SpringerLink
Log in

Noninvasive assessment of intraventricular pressure difference in left ventricular dyssynchrony using vector flow map**

  • Original Article
  • Published:
Heart and Vessels Aims and scope Submit manuscript

Abstract

Diastolic intraventricular pressure difference (IVPD) reflects left ventricular (LV) diastolic function. The relative pressure imaging (RPI) enables the noninvasive quantification of IVPD based on vector flow map** (VFM) and visualization of regional pressure distribution. LV dyssynchrony causes deterioration of cardiac performance. However, it remains unclear how IVPD is modulated by LV dyssynchrony. LV dyssynchrony was created in ten open-chest dogs by right ventricular (RV) pacing. The other ten dogs undergoing right atrial (RA) pacing set at the similar heart rate with RV pacing were used as controls. Echocardiographic images were acquired at baseline and during pacing simultaneously with LV pressure measurement by a micromanometer. Pressure difference (ΔP) was computed between the apex and the base of the LV inflow tract during a cardiac cycle by RPI and ΔP during isovolumic relaxation time (ΔPIRT), a parameter of diastolic suction, and that during early filling phase (ΔPE) were measured. During RV pacing, stroke volume (SV) and ΔPIRT decreased significantly, while ΔPE did not change compared to the baseline. During RA pacing, SV, ΔPIRT and ΔPE did not change significantly. ΔPIRT tended to correlate with –dP/dtmin and end-systolic volume, and significantly correlated with ejection fraction. IVPD during isovolumic relaxation time was decreased by LV dyssynchrony, while IVPD during early filling phase was not. A reduction of diastolic suction is observed in LV dyssynchrony and is significantly related to a decrease in SV.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Yotti R, Bermejo J, Benito Y, Antoranz JC, Desco MM, Rodríguez-Pérez D, Cortina C, Mombiela T, Barrio A, Elízaga J, Fernández-Avilés F (2011) Noninvasive estimation of the rate of relaxation by the analysis of intraventricular pressure gradients. Circ Cardiovasc Imaging 4:94–104

    Article  Google Scholar 

  2. Yotti R, Bermejo J, Antoranz JC, Rojo-Alvarez JL, Allue C, Silva J, Desco MM, Moreno M, Garcia-Fernández MA (2004) Noninvasive assessment of ejection intraventricular pressure gradients. J Am Coll Cardiol 43:1654–1662

    Article  Google Scholar 

  3. Firstenberg MS, Smedira NG, Greenberg NL, Prior DL, McCarthy PM, Garcia MJ, Thomas JD (2001) Relationship between early diastolic intraventricular pressure gradients, an index of elastic recoil, and improvements in systolic and diastolic function. Circulation 104:I330–I335

    Article  CAS  Google Scholar 

  4. Notomi Y, Popovic ZB, Yamada H, Wallick DW, Martin MG, Oryszak SJ, Shiota T, Greenberg NL, Thomas JD (2008) Ventricular untwisting: a temporal link between left ventricular relaxation and suction. Am J Physiol Heart Circ Physiol 294:H505–H513

    Article  CAS  Google Scholar 

  5. Yotti R, Bermejo J, Antoranz JC, Desco MM, Cortina C, Rojo-Alvarez JL, Allué C, Martín L, Moreno M, Serrano JA, Muñoz R, García-Fernández MA (2005) A noninvasive method for assessing impaired diastolic suction in patients with dilated cardiomyopathy. Circulation 112:2921–2929

    Article  Google Scholar 

  6. Nogami Y, Ishizu T, Atsumi A, Yamamoto M, Nakamura A, Machino-Ohtsuka T, Kawamura R, Seo Y, Aonuma K (2014) Diastolic suction in heart failure: impact of left ventricular geometry, untwist, and flow mechanics. Life Sci 102:111–117

    Article  CAS  Google Scholar 

  7. Ohara T, Niebel CL, Stewart KC, Charonko JJ, Pu M, Vlachos PP, Little WC (2012) Loss of adrenergic augmentation of diastolic intra-LV pressure difference in patients with diastolic dysfunction: evaluation by colour M-mode echocardiography. JACC Cardiovasc Imaging 5:861–870

    Article  Google Scholar 

  8. Stugaard M, Koriyama H, Katsuki K, Masuda K, Asanuma T, Takeda Y, Sakata Y, Itatani K, Nakatani S (2015) Energy loss in the left ventricle obtained by vector flow map** as a new quantitative measure of severity of aortic regurgitation: a combined experimental and clinical study. Eur Heart J Cardiovasc Imaging 16:723–730

    Article  Google Scholar 

  9. Tanaka T, Okada T, Nishimura T, Seki Y (2017) Relative pressure imaging in left ventricle using ultrasonic vector flow map**. Jpn J Appl Phys 56:07–26

    Google Scholar 

  10. Gürel E, Prinz C, Van Casteren L, Gao H, Willems R, Voigt JU (2016) The impact of function-flow interaction on left ventricular efficiency in patients with conduction abnormalities: a particle image velocimetry and tissue Doppler study. J Am Soc Echocardiogr 29:431–440

    Article  Google Scholar 

  11. Omar AM, Bansal M, Sengupta PP (2016) Advances in echocardiographic imaging in heart failure with reduced and preserved ejection fraction. Circ Res 119:357–374

    Article  CAS  Google Scholar 

  12. Itatani K, Okada T, Uejima T, Tanaka T, Ono M, Miyaji K, Takenaka K (2013) Intraventricular flow velocity vector visualization based on the continuity equation and measurements of vorticity and wall shear stress. Jpn J Appl Phys 52:07–16

    Article  Google Scholar 

  13. Asami R, Tanaka T, Kawabata KI, Hashiba K, Okada T, Nishiyama T (2017) Accuracy and limitations of vector flow map**: left ventricular phantom validation using stereo particle image velocimetory. J Echocardiogr 15:57–66

    Article  Google Scholar 

  14. Firstenberg MS, Greenberg NL, Garcia MJ, Thomas JD (2008) Relationship between ventricular contractility and early diastolic intraventricular pressure gradients: a diastolic link to systolic function. J Am Soc Echocardiogr 21:501–506

    Article  Google Scholar 

  15. Yanada A, Ohte N, Narita H, Akita S, Miyabe H, Takada N, Goto T, Mukai S, Hayano J, Kimura G (2003) The role of apically directed intraventricular isovolumic relaxation flow in speeding early diastolic left ventricular filling. J Am Soc Echocardiogr 16:1226–1230

    Article  Google Scholar 

  16. Lin MS, Lin JL, Liu YB, Wu CC, Lin LC, Chen MF (2006) Immediate impairment of left ventricular mechanical performance and force-frequency relation by rate-responsive dual-chamber, but not atrial pacing: Implications from intraventricular isovolumic relaxation flow. Int J Cardiol 109:367–374

    Article  Google Scholar 

  17. Nakatani S, Beppu S, Nagata S, Ishikura F, Tamai J, Yamagishi M, Ohmori F, Kimura K, Takamiya M, Miyatake K (1994) Diastolic suction in the human ventricle: observation during balloon mitral valvuloplasty with a single balloon. Am Heart J 127:143–147

    Article  CAS  Google Scholar 

  18. Udelson JE, Bacharach SL, Cannon RO 3rd, Bonow RO (1990) Minimum left ventricular pressure during beta-adrenergic stimulation in human subjects. evidence for elastic recoil and diastolic “suction” in the normal heart. Circulation 82:1174–1182

    Article  CAS  Google Scholar 

  19. Goliasch G, Goscinska-Bis K, Caracciolo G, Nakabo A, Smolka G, Pedrizzetti G, Narula J, Sengupta PP (2013) CRT improves LV filling dynamics: insights from echocardiographic particle imaging velocimetry. JACC Cardiovasc Imaging 6:704–713

    Article  Google Scholar 

  20. Pedrizzetti G, Martiniello AR, Bianchi V, D’Onofrio A, Caso P, Tonti G (2016) Changes in electrical activation modify the orientation of left ventricular flow momentum: novel observations using echocardiographic particle image velocimetry. Eur Heart J Cardiovasc Imaging 17:203–209

    Article  Google Scholar 

Download references

Acknowledgements

We thank Mr. Takashi Okada (Hitachi) and Mr. Tomohiko Tanaka (Hitachi) for technical advice and development of vector flow map**.

Author information

Authors and Affiliations

  1. Division of Functional Diagnostics, Department of Health Sciences, Osaka University Graduate School of Medicine, 1-7 Yamadaoka, Suita, Osaka, 565-0871, Japan

    Seina Minami, Kasumi Masuda, Marie Stugaard, Toshiki Kamimukai & Toshihiko Asanuma

  2. Saiseikai Senri Hospital, 1-1-6 Tsukumodai, Suita, Osaka, 565-0862, Japan

    Satoshi Nakatani

Authors
  1. Seina Minami
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kasumi Masuda
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Marie Stugaard
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Toshiki Kamimukai
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Toshihiko Asanuma
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Satoshi Nakatani
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Satoshi Nakatani.

Ethics declarations

Conflict of interest

Dr. Nakatani has received a research grant from Hitachi. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Minami, S., Masuda, K., Stugaard, M. et al. Noninvasive assessment of intraventricular pressure difference in left ventricular dyssynchrony using vector flow map**. Heart Vessels 36, 92–98 (2021). https://doi.org/10.1007/s00380-020-01664-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00380-020-01664-3

Keywords

Search

Navigation