title: The role of apically directed intraventricular isovolumic relaxation flow in speeding early diastolic left ventricular filling.
abstract: Left ventricular (LV) systolic performance has been acknowledged to have a close relation to LV early diastolic filling and LV relaxation. However, the mechanism showing how good LV systolic function enhances the LV early diastolic filling has not been fully elucidated from the viewpoint of intraventricular flow dynamics. Thus, we investigated this issue in 82 patients with suggested coronary artery disease who underwent cardiac catheterization. Apically directed intraventricular isovolumic relaxation flow (IRF) and the propagation velocity of early diastolic filling flow were measured using pulsed and color Doppler echocardiography. LV ejection fraction and LV relaxation time constant tau were obtained in cardiac catheterization. As we were not able to measure the IRF velocity less than 14 cm/s that was limited by a Doppler low-cut filter, we analyzed the data collected from 78 patients with measurable IRF velocity. The IRF velocity significantly correlated with LV ejection fraction (r = 0.74, P <.001) and with LV relaxation time constant tau (r = -0.31, P <.01). The propagation velocity of early diastolic filling flow significantly correlated with the IRF velocity (r = 0.73, P <.001) and also significantly correlated with LV ejection fraction (r = 0.70, P <.001). Good LV systolic performance augments LV early diastolic filling directly, mediated by IRF. A faster IRF velocity may play a role in delivering good LV systolic performance to LV early diastolic filling.
authors.affiliation: Department of Internal Medicine and Pathophysiology, Nagoya City University Graduate School of Medical Sciences, Japan.
authors.forename: Atsumi
authors.initials: A
authors.lastname: Yanada
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Ohte
authors.forename: Hitomi
authors.initials: H
authors.lastname: Narita
authors.forename: Sachie
authors.initials: S
authors.lastname: Akita
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Miyabe
authors.forename: Norio
authors.initials: N
authors.lastname: Takada
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Goto
authors.forename: Seiji
authors.initials: S
authors.lastname: Mukai
authors.forename: Junichiro
authors.initials: J
authors.lastname: Hayano
authors.forename: Genjiro
authors.initials: G
authors.lastname: Kimura
mesh_terms: D001783:Blood Flow Velocity; D003324:Coronary Artery Disease / Q000503:physiopathology; D003971:Diastole / Q000502:physiology*; D018619:Echocardiography, Doppler, Pulsed; D006801:Humans; D008875:Middle Aged; D013318:Stroke Volume / Q000502:physiology; D013599:Systole / Q000502:physiology*; D016277:Ventricular Function, Left / Q000502:physiology*