title: Impact of left ventricular volume/mass ratio on diastolic function.
abstract: OBJECTIVE
  To assess the impact of left ventricular (LV) volume/mass ratio on diastolic function parameters in subjects with dilated cardiomyopathy (DCM) or hypertrophic cardiomyopathy (HCM) and healthy controls.
  
  
  RESULTS
  We performed echocardiography in 44 healthy controls, 35 HCM subjects, 29 DCM subjects with narrow QRS complex (DCM-n), and 27 DCM subjects with wide QRS complex (DCM-w). Mitral annulus velocity (E(a)) and transmitral E-wave velocity were used to estimate time constant of isovolumic pressure decay (tau). LV flow propagation velocity (V(p)) and early intraventricular pressure gradient (IVPG) were derived from colour M-mode of LV inflow. We calculated LV twist and peak untwisting rate (UntwR) by speckle tracking. Mean LV volume/mass ratio was 0.34 +/- 0.09 mL/g in healthy controls, 0.15 +/- 0.06 mL/g in HCM, 0.6 +/- 0.2 mL/g in DCM-n, and 0.8 +/- 0.3 mL/g in DCM-w patients (P < 0.001 for all groups). Resting LV ejection fractions were 63 +/- 7, 64 +/- 8, 31 +/- 8, and 26 +/- 8%, respectively (P < 0.01 vs. controls for DCM groups). In a multivariate analysis, LV volume/mass ratio remained a strong independent predictor of V(p) (P < 0.001), IVPG (P = 0.009), and UntwR (P < 0.001) but not for E(a) (P = 0.25).
  
  
  CONCLUSIONS
  LV volume/mass ratio had influences on diastolic function parameters independent of intrinsic diastolic function and filling pressures. It should be considered when assessing patients suspected of LV diastolic dysfunction.
authors.affiliation: Division of Cardiovascular Medicine, Department of Cardiology, Desk F-15, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
authors.forename: Adisai
authors.initials: A
authors.lastname: Buakhamsri
authors.forename: Zoran B
authors.initials: ZB
authors.lastname: Popovic
authors.forename: Jingna
authors.initials: J
authors.lastname: Lin
authors.forename: Pascal
authors.initials: P
authors.lastname: Lim
authors.forename: Neil L
authors.initials: NL
authors.lastname: Greenberg
authors.forename: Allen G
authors.initials: AG
authors.lastname: Borowski
authors.forename: W H Wilson
authors.initials: WH
authors.lastname: Tang
authors.forename: Allan L
authors.initials: AL
authors.lastname: Klein
authors.forename: Harry M
authors.initials: HM
authors.lastname: Lever
authors.forename: Milind Y
authors.initials: MY
authors.lastname: Desai
authors.forename: James D
authors.initials: JD
authors.lastname: Thomas
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001783:Blood Flow Velocity; D002311:Cardiomyopathy, Dilated / Q000000981:diagnostic imaging / Q000503:physiopathology*; D002312:Cardiomyopathy, Hypertrophic / Q000000981:diagnostic imaging / Q000503:physiopathology*; D016022:Case-Control Studies; D003971:Diastole / Q000502:physiology; D004452:Echocardiography / Q000379:methods; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D008875:Middle Aged; D008943:Mitral Valve / Q000502:physiology; D015203:Reproducibility of Results; D013318:Stroke Volume / Q000502:physiology; D013599:Systole / Q000502:physiology; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000503:physiopathology*; D016277:Ventricular Function, Left; D017725:Ventricular Pressure / Q000502:physiology; D055815:Young Adult