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Echocardiographic Assessment of Cardiac Anatomy and Function in Adult Rats
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Early left ventricular diastolic function quantitation using directional impedances.

Erina Ghosh1, Sándor J Kovács

  • 1Cardiovascular Biophysics Laboratory, Cardiovascular Division, Washington University School of Medicine, Box 8086, 660 South Euclid Ave., St. Louis, MO 63110, USA.

Annals of Biomedical Engineering
|February 2, 2013
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Summary

This study introduces longitudinal (Z(L)) and transverse (Z(T)) impedance to quantify left ventricular (LV) diastolic function. Lower Z(L) reveals the heart

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Area of Science:

  • Cardiovascular Physiology
  • Biomedical Engineering
  • Cardiac Mechanics

Background:

  • Impedance analysis quantifies circulatory opposition to pulsatile blood flow.
  • Diastolic function (DF) assessment traditionally uses the early diastolic left ventricular (LV) pressure-flow relationship.
  • Normal LV filling involves longitudinal expansion and transverse dimension increase.

Purpose of the Study:

  • To quantify directional LV filling properties during early diastole.
  • To introduce and calculate longitudinal (Z(L)) and transverse (Z(T)) impedance during the E-wave.
  • To compare Z(L) and Z(T) to understand LV volume accommodation.

Main Methods:

  • Calculation of Z(L) and Z(T) from simultaneous transmitral flow and LV pressure data.
  • Analysis of 578 cardiac cycles in 17 subjects with normal LV function.
  • Normalization of Z(T) by LV cross-sectional area (Ž(T)) for direct comparison with Z(L).

Main Results:

  • Average Z(L) was 0.7 ± 0.4 mmHg s/cm(4) and average Z(T) was 238 ± 316 mmHg s/cm(2).
  • Physiologic Z(L) is approximately 34 times smaller than Ž(T), indicating preference for longitudinal accommodation.
  • Lowest impedance values were observed in the first harmonic, increasing with higher harmonics.

Conclusions:

  • Z(L) and Z(T) effectively characterize longitudinal and transverse chamber properties of diastolic function.
  • Diastolic dysfunction can be conceptualized as an impedance mismatch.
  • This impedance-based approach offers novel insights into diastolic mechanics.