The wall-thinning to transmitral flow-velocity relation: derivation with in vivo validation.
Motion of the endocardial surface in diastole is the resultant effect of wall thinning. Endocardial wall motion to transmitral flow (Doppler E-wave) relations that predict wall thinning are derived using conservation of myocardial volume, two simplified (spatiotemporally homogeneous) left ventricular (LV) geometric models and the constant-volume pump attribute of the heart. For validation, model-predicted vs. color M-mode recorded maximum rate of wall thinning was compared in (n = 15) normal controls. Excellent agreement for both models (r = 0.84, r = 0.86) was observed. For abnormal LV function (n = 15), model-predicted vs. M-mode recorded maximum rate of wall-thinning correlated poorly (r = -0.28, r = -0.22). We conclude that, in normal ventricles, the Doppler E-wave and wall thinning are related through the constant-volume attribute of the heart and its geometry. Pathologic cases are governed by the same principles, but the filling to wall-thinning relation is altered by spatiotemporal inhomogeneities in geometry and wall motion.
Cardiovascular Biophysics Laboratory, Cardiovascular Division, Washington University School of Medicine, St Louis, MO 63110, USA.
Danielle
D
Cook
Mark
M
Sessoms
Sándor J
SJ
Kovács
D000328:Adult; D000368:Aged; D001783:Blood Flow Velocity; D002306:Cardiac Volume / Q000502:physiology; D003971:Diastole / Q000502:physiology; D004699:Endocardium / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006801:Humans; D008875:Middle Aged; D008943:Mitral Valve / Q000502:physiology; D008954:Models, Biological; D013599:Systole / Q000502:physiology; D014463:Ultrasonography