title: Noninvasive assessment of wall distensibility with the evaluation of diastolic epicardial movement.
abstract: BACKGROUND
  Left ventricular (LV) wall stiffening plays an important role in the development of heart failure with preserved ejection fraction (HFpEF). Based on the linear elastic theory, we hypothesized that the evaluation of epicardial movement during diastole is helpful for the noninvasive assessment of LV wall distensibility.
  
  
  RESULTS
  Based on the linear elastic theory, the epicardial movement index (EMI) was calculated on the echocardiogram as: [see text.] We calculated diastolic wall strain (DWS) as follows to examine whether DWS substitutes for EMI: [see text.] The animal study using hypertensive Dahl salt-sensitive rats, HFpEF model, and normotensive Dahl rats showed the significant and inverse correlation of EMI or DWS with myocardial stiffness constant. Preload alteration did not affect EMI or DWS. In the clinical study, the HFpEF patients had lower EMI and DWS than the normal volunteers and the asymptomatic patients with LV hypertrophy.
  
  
  CONCLUSIONS
  The evaluation of epicardial movement may be useful in noninvasively assessing wall distensibility in the absence of LV systolic dysfunction.
authors.affiliation: Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan.
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Takeda
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Sakata
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Higashimori
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Mano
authors.forename: Mayu
authors.initials: M
authors.lastname: Nishio
authors.forename: Tomohito
authors.initials: T
authors.lastname: Ohtani
authors.forename: Masatsugu
authors.initials: M
authors.lastname: Hori
authors.forename: Tohru
authors.initials: T
authors.lastname: Masuyama
authors.forename: Makoto
authors.initials: M
authors.lastname: Kaneko
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Yamamoto
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D054144:Heart Failure, Diastolic / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006439:Hemodynamics; D008297:Male; D008954:Models, Biological; D010496:Pericardium / Q000000981:diagnostic imaging / Q000503:physiopathology*; D051381:Rats; D020303:Rats, Inbred Dahl; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000503:physiopathology*