Solution of the 'inverse problem of diastole' via kinematic modeling allows determination of ventricular properties and provides mechanistic insights into diastolic heart failure

Research output: Chapter in Book/Report/Conference proceedingConference contribution

4 Scopus citations

Abstract

Because 50% of heart failure hospital admissions have diastolic heart failure (DHF) quantifying diastolic function (DF) has reached new prominence. Conventionally DF indices have been computed from shape-based features (height, duration, area) of Doppler waveforms such as the E-wave, (transmitral flow velocity), or E'-wave (mitral annular velocity) without regard to causal mechanisms. Solution of the 'inverse problem' has been achieved via the parametrized diastolic filling (PDF) formalism, a linear, kinematic model which treats the elastic, recoil-driven suction-pump attribute of the left ventricle as a damped simple harmonic oscillator (SHO). PDF uses the E-wave as input and generates stiffness (k), relaxation/ damping (c) and load (x0) as output. Scientific successes include the prediction that filling must be driven by a linear, bi-directional spring, later validated as a property of the giant cardiac protein titin, which generates a recoiling force at the cellular level in early diastole. Selected recent kinematic modeling achievements include: explanation why E-wave deceleration time must be determined jointly by stiffness (k) and relaxation (c), rather than by stiffness alone; LV equilibrium volume is the volume at diastasis; solution of the load-independent index of diastolic function (LIIDF) problem; solution of the isovolumic pressure decay (IVPD) problem. Clinical application reveals that contrary to dogma, chamber relaxation/viscoelasticity (PDF parameter c) rather than chamber stiffness (PDF parameter k) most often differentiates between controls vs. diastolic dysfunction subjects, thereby providing mechanistic insights into DHF.

Original languageEnglish
Title of host publicationProceedings of the 31st Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Subtitle of host publicationEngineering the Future of Biomedicine, EMBC 2009
PublisherIEEE Computer Society
Pages2354-2357
Number of pages4
ISBN (Print)9781424432967
DOIs
StatePublished - Jan 1 2009
Event31st Annual International Conference of the IEEE Engineering in Medicine and Biology Society: Engineering the Future of Biomedicine, EMBC 2009 - Minneapolis, MN, United States
Duration: Sep 2 2009Sep 6 2009

Publication series

NameProceedings of the 31st Annual International Conference of the IEEE Engineering in Medicine and Biology Society: Engineering the Future of Biomedicine, EMBC 2009

Conference

Conference31st Annual International Conference of the IEEE Engineering in Medicine and Biology Society: Engineering the Future of Biomedicine, EMBC 2009
CountryUnited States
CityMinneapolis, MN
Period09/2/0909/6/09

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    Kovács, S. J. (2009). Solution of the 'inverse problem of diastole' via kinematic modeling allows determination of ventricular properties and provides mechanistic insights into diastolic heart failure. In Proceedings of the 31st Annual International Conference of the IEEE Engineering in Medicine and Biology Society: Engineering the Future of Biomedicine, EMBC 2009 (pp. 2354-2357). [5335021] (Proceedings of the 31st Annual International Conference of the IEEE Engineering in Medicine and Biology Society: Engineering the Future of Biomedicine, EMBC 2009). IEEE Computer Society. https://doi.org/10.1109/IEMBS.2009.5335021