The peak atrioventricular pressure gradient to transmitral flow relation: Kinematic model prediction with in vivo validation

Lisa Bauman, Charles S. Chung, Mustafa Karamanoglu, Sándor J. Kovács

Research output: Contribution to journalArticlepeer-review

35 Scopus citations

Abstract

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.

Original languageEnglish
Pages (from-to)839-844
Number of pages6
JournalJournal of the American Society of Echocardiography
Volume17
Issue number8
DOIs
StatePublished - Aug 2004

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