Impact of Acute Moderate Elevation in Left Ventricular Afterload on Diastolic Transmitral Flow Efficiency: Analysis by Vortex Formation Time

Panupong Jiamsripong; Anna M. Calleja; Mohsen S. Alharthi; Mate Dzsinich; Eileen M. McMahon; Jeffrey J. Heys; Michele Milano; Partho P. Sengupta; Bijoy K. Khandheria; Marek Belohlavek

doi:10.1016/j.echo.2008.12.006

Impact of Acute Moderate Elevation in Left Ventricular Afterload on Diastolic Transmitral Flow Efficiency: Analysis by Vortex Formation Time

Panupong Jiamsripong, Anna M. Calleja, Mohsen S. Alharthi, Mate Dzsinich, Eileen M. McMahon, Jeffrey J. Heys, Michele Milano, Partho P. Sengupta, Bijoy K. Khandheria, Marek Belohlavek

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Research output: Contribution to journal › Article › peer-review

37 Scopus citations

Abstract

Background: The formation of a vortex alongside a diastolic jet signifies an efficient blood transport mechanism. Vortex formation time (VFT) is an index of the optimal conditions for vortex formation. It was hypothesized that left ventricular (LV) afterload impairs diastolic transmitral flow efficiency and therefore shifts the VFT out of its optimal range. Methods: In 9 open-chest pigs, LV afterload was elevated by externally constricting the ascending aorta and increasing systolic blood pressure to 130% of baseline value for 3 minutes. Results: Systolic LV function decreased, diastolic filling velocity increased only during the late (atrial) phase from 0.46 ± 0.06 to 0.63 ± 0.19 m/s (P = .0231), and end-diastolic LV volume and heart rate remained unchanged. VFT decreased from 4.09 ± 0.27 to 2.78 ± 1.03 (P = .0046). Conclusion: An acute, moderate elevation in LV afterload worsens conditions for diastolic vortex formation, suggesting impaired blood transport efficiency.

Original language	English (US)
Pages (from-to)	427-431
Number of pages	5
Journal	Journal of the American Society of Echocardiography
Volume	22
Issue number	4
DOIs	https://doi.org/10.1016/j.echo.2008.12.006
State	Published - Apr 2009

Keywords

Blood flow velocity
Diastolic filling
Vortex formation

ASJC Scopus subject areas

Radiology Nuclear Medicine and imaging
Cardiology and Cardiovascular Medicine

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10.1016/j.echo.2008.12.006

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Jiamsripong, P., Calleja, A. M., Alharthi, M. S., Dzsinich, M., McMahon, E. M., Heys, J. J., Milano, M., Sengupta, P. P., Khandheria, B. K., & Belohlavek, M. (2009). Impact of Acute Moderate Elevation in Left Ventricular Afterload on Diastolic Transmitral Flow Efficiency: Analysis by Vortex Formation Time. Journal of the American Society of Echocardiography, 22(4), 427-431. https://doi.org/10.1016/j.echo.2008.12.006

Impact of Acute Moderate Elevation in Left Ventricular Afterload on Diastolic Transmitral Flow Efficiency: Analysis by Vortex Formation Time. / Jiamsripong, Panupong; Calleja, Anna M.; Alharthi, Mohsen S. et al.
In: Journal of the American Society of Echocardiography, Vol. 22, No. 4, 04.2009, p. 427-431.

Research output: Contribution to journal › Article › peer-review

Jiamsripong, P, Calleja, AM, Alharthi, MS, Dzsinich, M, McMahon, EM, Heys, JJ, Milano, M, Sengupta, PP, Khandheria, BK & Belohlavek, M 2009, 'Impact of Acute Moderate Elevation in Left Ventricular Afterload on Diastolic Transmitral Flow Efficiency: Analysis by Vortex Formation Time', Journal of the American Society of Echocardiography, vol. 22, no. 4, pp. 427-431. https://doi.org/10.1016/j.echo.2008.12.006

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abstract = "Background: The formation of a vortex alongside a diastolic jet signifies an efficient blood transport mechanism. Vortex formation time (VFT) is an index of the optimal conditions for vortex formation. It was hypothesized that left ventricular (LV) afterload impairs diastolic transmitral flow efficiency and therefore shifts the VFT out of its optimal range. Methods: In 9 open-chest pigs, LV afterload was elevated by externally constricting the ascending aorta and increasing systolic blood pressure to 130% of baseline value for 3 minutes. Results: Systolic LV function decreased, diastolic filling velocity increased only during the late (atrial) phase from 0.46 ± 0.06 to 0.63 ± 0.19 m/s (P = .0231), and end-diastolic LV volume and heart rate remained unchanged. VFT decreased from 4.09 ± 0.27 to 2.78 ± 1.03 (P = .0046). Conclusion: An acute, moderate elevation in LV afterload worsens conditions for diastolic vortex formation, suggesting impaired blood transport efficiency.",

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note = "Funding Information: This study was supported by grant HL68573 (M.B.) from the National Institutes of Health (Bethesda, MD) and by an Arizona State University and Mayo Clinic seed grant (J.J.H., M.M., M.B.). Dr Belohlavek's research is funded in part by GE Healthcare, Milwaukee, WI. ",

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AU - Alharthi, Mohsen S.

AU - Dzsinich, Mate

AU - McMahon, Eileen M.

AU - Heys, Jeffrey J.

AU - Milano, Michele

AU - Sengupta, Partho P.

AU - Khandheria, Bijoy K.

AU - Belohlavek, Marek

N1 - Funding Information: This study was supported by grant HL68573 (M.B.) from the National Institutes of Health (Bethesda, MD) and by an Arizona State University and Mayo Clinic seed grant (J.J.H., M.M., M.B.). Dr Belohlavek's research is funded in part by GE Healthcare, Milwaukee, WI.

PY - 2009/4

Y1 - 2009/4

N2 - Background: The formation of a vortex alongside a diastolic jet signifies an efficient blood transport mechanism. Vortex formation time (VFT) is an index of the optimal conditions for vortex formation. It was hypothesized that left ventricular (LV) afterload impairs diastolic transmitral flow efficiency and therefore shifts the VFT out of its optimal range. Methods: In 9 open-chest pigs, LV afterload was elevated by externally constricting the ascending aorta and increasing systolic blood pressure to 130% of baseline value for 3 minutes. Results: Systolic LV function decreased, diastolic filling velocity increased only during the late (atrial) phase from 0.46 ± 0.06 to 0.63 ± 0.19 m/s (P = .0231), and end-diastolic LV volume and heart rate remained unchanged. VFT decreased from 4.09 ± 0.27 to 2.78 ± 1.03 (P = .0046). Conclusion: An acute, moderate elevation in LV afterload worsens conditions for diastolic vortex formation, suggesting impaired blood transport efficiency.

AB - Background: The formation of a vortex alongside a diastolic jet signifies an efficient blood transport mechanism. Vortex formation time (VFT) is an index of the optimal conditions for vortex formation. It was hypothesized that left ventricular (LV) afterload impairs diastolic transmitral flow efficiency and therefore shifts the VFT out of its optimal range. Methods: In 9 open-chest pigs, LV afterload was elevated by externally constricting the ascending aorta and increasing systolic blood pressure to 130% of baseline value for 3 minutes. Results: Systolic LV function decreased, diastolic filling velocity increased only during the late (atrial) phase from 0.46 ± 0.06 to 0.63 ± 0.19 m/s (P = .0231), and end-diastolic LV volume and heart rate remained unchanged. VFT decreased from 4.09 ± 0.27 to 2.78 ± 1.03 (P = .0046). Conclusion: An acute, moderate elevation in LV afterload worsens conditions for diastolic vortex formation, suggesting impaired blood transport efficiency.

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Impact of Acute Moderate Elevation in Left Ventricular Afterload on Diastolic Transmitral Flow Efficiency: Analysis by Vortex Formation Time

Abstract

Keywords

ASJC Scopus subject areas

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