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AJP - Heart and Circulatory Physiology, Vol 252, Issue 1 178-H187, Copyright © 1987 by American Physiological Society
ARTICLES |
S. J. Kovacs Jr, B. Barzilai and J. E. Perez
A new parametrized diastolic filling (PDF) formalism for evaluation of holodiastolic (left and right) ventricular function via Doppler echocardiography is presented. It is motivated by the empiric observation that during diastole the heart behaves as a suction pump whose dynamics, in certain respects, are those of a damped harmonic oscillator. An expression for elastic recoil (suction) initiated ventricular diastolic fluid inflow velocity v(t) is obtained by differentiation from the solution x(t) of the linear differential equation that describes the motion of a forced, damped harmonic oscillator. It is solved for "over-damped" motion, for zero initial velocity and initial displacement = xo cm. An explicit forcing term F(t) = Fosin(omega t) is included to account for late diastolic (atrial) filling. The quantitative parameters of the model include inertia (mass; m), viscosity (damping constant; c), source of stored energy for suction (spring constant; k), and its initial displacement xo, the amplitude and frequency of the (atrial) forcing term Fo, omega. The mathematical behavior of the solution v(t) and its dependence on the parameters xo, c, and k, which characterize the contour of the Doppler velocity profile (DVP), is discussed. When clinical examples of normal and abnormal transmitral DVPs are compared with v(t) calculated using the harmonic oscillator model, excellent agreement [DVP-v(t)]/v(t) approximately 0.05 is obtained throughout diastole. Thus the model allows accurate qualitative and quantitative characterization of global ventricular diastolic behavior by noninvasive means in a variety of normal and abnormal stiffness-compliance states. In addition, it may serve as a prototype for a class of mathematical models that can encompass the essential dynamic elements of ventricular diastolic function that couple to flow and further enhance the role of the heart as a suction pump.
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C. S. Chung, M. Karamanoglu, and S. J. Kovacs Duration of diastole and its phases as a function of heart rate during supine bicycle exercise Am J Physiol Heart Circ Physiol, November 1, 2004; 287(5): H2003 - H2008. [Abstract] [Full Text] [PDF]
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A. W. Bowman, P. A. Frihauf, and S. J. Kovacs Time-varying effective mitral valve area: prediction and validation using cardiac MRI and Doppler echocardiography in normal subjects Am J Physiol Heart Circ Physiol, October 1, 2004; 287(4): H1650 - H1657. [Abstract] [Full Text] [PDF]
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A. W. Bowman and S. J. Kovacs Assessment and consequences of the constant-volume attribute of the four-chambered heart Am J Physiol Heart Circ Physiol, November 1, 2003; 285(5): H2027 - H2033. [Abstract] [Full Text] [PDF]
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J. B. Lisauskas, J. Singh, A. W. Bowman, and S. J. Kovacs Chamber properties from transmitral flow: prediction of average and passive left ventricular diastolic stiffness J Appl Physiol, July 1, 2001; 91(1): 154 - 162. [Abstract] [Full Text] [PDF]
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 A. L. Manson, S. P. Nudelman, M. T. Hagley, A. F. Hall, and S. J. Kovacs Relationship of the Third Heart Sound to Transmitral Flow Velocity Deceleration Circulation, August 1, 1995; 92(3): 388 - 394. [Abstract] [Full Text]
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