Noninvasive assessment of diastolic function in subjects with preserved left ventricular ejection fraction: usefulness of color kinetic imaging.
BACKGROUND
Noninvasive assessment of left ventricular (LV) diastolic function is not established in patients with preserved ejection fraction. We investigated a relation between diastolic function and diastolic wall dynamics.


RESULTS
In the animal study, data were collected in hypertensive Dahl salt-sensitive rats, a diastolic heart failure (DHF) model (n = 35), and normotensive Dahl rats (n = 26). In the clinical study, echocardiography was conducted in 26 diabetic patients with normal ejection fraction and 10 age-matched controls. The diastolic index of color-encoded images (color kinesis diastolic index [CK-DI]) was calculated as the ratio of LV cavity area expansion during the first 30% of diastolic filling time to that during the whole diastolic filling period. In the DHF model, the E/A ratio of the transmitral flow velocity curves was pseudonormalized with the development of heart failure, but CK-DI was not. CK-DI, not E/A, was significantly and inversely correlated with the time constant of LV relaxation. Angiotensin receptor blocker improved LV relaxation in the DHF model and increased CK-DI, but not E/A. The diabetic patients showed lower CK-DI than the controls, although E/A was not different.


CONCLUSIONS
Color-encoded imaging is useful in evaluating LV diastolic function. The prevalence of LV diastolic dysfunction may have been clinically underestimated by the transmitral flow velocity curves.
Takeda
Yasuharu
Y
Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan.
Sakata
Yasushi
Y
Mano
Toshiaki
T
Nishio
Mayu
M
Ohtani
Tomohito
T
Hori
Masatsugu
M
Masuyama
Tohru
T
Yamamoto
Kazuhiro
K
D000328:Adult; D057911:Angiotensin Receptor Antagonists; D000818:Animals; D001783:Blood Flow Velocity / Q000502:physiology; D016022:Case-Control Studies; D003116:Color; D003920:Diabetes Mellitus / Q000000981:diagnostic imaging / Q000503:physiopathology; D003971:Diastole / Q000502:physiology; D004195:Disease Models, Animal; D004452:Echocardiography / Q000379:methods*; D015150:Echocardiography, Doppler; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000503:physiopathology; D006352:Heart Ventricles / Q000187:drug effects / Q000503:physiopathology; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000502:physiology; D011667:Pulmonary Veins / Q000503:physiopathology; D051381:Rats; D020303:Rats, Inbred Dahl; D013318:Stroke Volume / Q000187:drug effects / Q000502:physiology*; D016277:Ventricular Function, Left / Q000187:drug effects / Q000502:physiology*; D017725:Ventricular Pressure / Q000187:drug effects / Q000502:physiology
D057911:Angiotensin Receptor Antagonists