TY - JOUR
T1 - The peak atrioventricular pressure gradient to transmitral flow relation
T2 - Kinematic model prediction with in vivo validation
AU - Bauman, Lisa
AU - Chung, Charles S.
AU - Karamanoglu, Mustafa
AU - Kovács, Sándor J.
N1 - Funding Information:
Supported in part by the Heartland Affiliate of the American Heart Association (Dallas, Texas), the Whitaker Foundation (Roslyn Virginia), the National Institutes of Health (HL54179, HL04023 Bethesda, Maryland), and the Alan A. and Edith L. Wolff Charitable Trust (St Louis, Missouri).
PY - 2004/8
Y1 - 2004/8
N2 - Physiologists and cardiologists estimate peak transvalvular pressure gradients (ΔP) by Doppler echocardiographic imaging of peak flow velocities using the simplified Bernoulli relationship: ΔP (mm Hg) = 4V2 (m/s). Because left ventricular filling is initiated by mechanical suction, V can be predicted by the motion of a simple harmonic oscillator by the parametrized diastolic filling formalism that characterizes E-wave contours by 3 unique simple harmonic oscillator parameters: initial displacement (xo cm); spring constant (k g/s2); and damping constant (c g/s). Parametrized diastolic filling predicts peak atrioventricular pressure gradient as kxo, the peak simple harmonic oscillator force. For validation, simultaneous (micromanometric) left ventricular pressure and E-wave data from 19 patients were analyzed. Model-predicted peak gradient (kxo) was compared with actual gradient (ΔPcath) and with 4V2. Multiple linear regression results for all patients yielded highly significant relation between kx o and ΔPcath (kxo = m1Δ Pcath + b1, where m1 = 40.7 ± 8.0 dyne/mm Hg, b1 = 1540 ± 116 dyne, r2 = 0.97, P < .001). Regression analysis showed no significant correlation between 4V 2 and ΔPcath (4V2 = m2Δ Pcath + b2, where m2 = 0.01 ± 0.03, m2/s2/mm Hg and b2 = 2.07 ± 0.44 m 2/s2, P = nonsignificant). We conclude that E-wave analysis by parametrized diastolic filling predicts peak atrioventricular gradients reliably and more accurately than 4V2.
AB - Physiologists and cardiologists estimate peak transvalvular pressure gradients (ΔP) by Doppler echocardiographic imaging of peak flow velocities using the simplified Bernoulli relationship: ΔP (mm Hg) = 4V2 (m/s). Because left ventricular filling is initiated by mechanical suction, V can be predicted by the motion of a simple harmonic oscillator by the parametrized diastolic filling formalism that characterizes E-wave contours by 3 unique simple harmonic oscillator parameters: initial displacement (xo cm); spring constant (k g/s2); and damping constant (c g/s). Parametrized diastolic filling predicts peak atrioventricular pressure gradient as kxo, the peak simple harmonic oscillator force. For validation, simultaneous (micromanometric) left ventricular pressure and E-wave data from 19 patients were analyzed. Model-predicted peak gradient (kxo) was compared with actual gradient (ΔPcath) and with 4V2. Multiple linear regression results for all patients yielded highly significant relation between kx o and ΔPcath (kxo = m1Δ Pcath + b1, where m1 = 40.7 ± 8.0 dyne/mm Hg, b1 = 1540 ± 116 dyne, r2 = 0.97, P < .001). Regression analysis showed no significant correlation between 4V 2 and ΔPcath (4V2 = m2Δ Pcath + b2, where m2 = 0.01 ± 0.03, m2/s2/mm Hg and b2 = 2.07 ± 0.44 m 2/s2, P = nonsignificant). We conclude that E-wave analysis by parametrized diastolic filling predicts peak atrioventricular gradients reliably and more accurately than 4V2.
UR - http://www.scopus.com/inward/record.url?scp=3342950412&partnerID=8YFLogxK
U2 - 10.1016/j.echo.2004.04.017
DO - 10.1016/j.echo.2004.04.017
M3 - Article
C2 - 15282487
AN - SCOPUS:3342950412
VL - 17
SP - 839
EP - 844
JO - Journal of the American Society of Echocardiography
JF - Journal of the American Society of Echocardiography
SN - 0894-7317
IS - 8
ER -