title: Physiological basis and clinical significance of left ventricular suction studied using echo-dynamography.
abstract: BACKGROUND
  The existence as well as the exact genesis of left ventricular suction during rapid filling phase have been controversial. In the present study, we aimed at resolution of this problem using noninvasive and sophisticated ultrasonic methods. The clinical meaning was also documented.
  
  
  METHODS
  Ten healthy male volunteers were examined by 2D echocardiography and echo-dynamography which enables us to obtain detailed instantaneous data of blood flow and wall motion simultaneously from the wide range of the left ventricle. The correlation of blood flow and wall motion was also studied.
  
  
  RESULTS
  Rapid ventricular filling was divided into 2 phases which had different physiology. The early half (early rapid filling: ERF) showed the effect which was alike drawing a piston. This was proved by the shape of the velocity of inflow and the basal muscle contraction which actively assisted extension of the relaxed apical and central parts of the left ventricle, giving the negative pressure which causes the ventricular suction. The later half (late rapid filling: LRF) showed the turning of the fundamental flow and the squeezed basal part just like the sphincter in addition to the expansion of the apical and central portions of the left ventricle, and all of these cooperatively augmented the suction effect.
  
  
  CONCLUSIONS
  Ventricular suction does exist to help ventricular filling. Simultaneous appearance of the contraction in the basal part and the relaxation or extension in the apical part during the post-ejection transitional period was made to occur the suction in the LV. And it can be said that the suction appeared in the late stage of systole as the one of the serial systolic phenomena.
authors.affiliation: Cardiovascular Center, Tohoku Welfare Pension Hospital, Fukumuro 1-12-1, Miyagino-ku, Sendai 983-0005, Japan. m.tanaka@jata-miyagi.org
authors.forename: Motonao
authors.initials: M
authors.lastname: Tanaka
authors.forename: Tsuguya
authors.initials: T
authors.lastname: Sakamoto
authors.forename: Shigeo
authors.initials: S
authors.lastname: Sugawara
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nakajima
authors.forename: Takeyoshi
authors.initials: T
authors.lastname: Kameyama
authors.forename: Haruna
authors.initials: H
authors.lastname: Tabuchi
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Katahira
authors.forename: Shigeo
authors.initials: S
authors.lastname: Ohtsuki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kanai
mesh_terms: D000328:Adult; D001783:Blood Flow Velocity; D004452:Echocardiography / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D016277:Ventricular Function, Left / Q000502:physiology*