Striking effect of left ventricular systolic performance on propagation velocity of left ventricular early diastolic filling flow

Propagation velocity of left ventricular (IV) early diastolic filling flow (PVE) has been acknowledged as a useful parameter for IV early diastolic pe rformance; however, the effect of IV systolic performance on PVE is not ful ly understood. Thus the purpose of this study was to investigate such an ef fect. Propagation of IV early diastolic filling flow was visualized by M-mo de color Doppler imaging, and the slopes of the peak velocity tracings were measured as PVE in 150 patients who underwent coronary angiography. In car diac catheterization, mean pulmonary capillary wedge pressure, time constan t tau of IV pressure decay, IV end-systolic volume index, and IV ejection f raction were obtained. In univariate regression analysis, PVE significantly correlated with IV end-systolic volume index (r = -0.68, P < .001), LV eje ction fraction (r = 0.66, P < .001), and time constant tau (r = -0.52, P < .001). in multivariate regressionanalysis, PVE was regressed by the IV end- systolic volume index, tau, and mean pulmonary capillary wedge pressure. Th e contribution of each parameter to the variance of the PVE was 46%, 3%, an d 2%, respectively. A break-point linear regression analysis showed that th e relation between the IV end-systolic volume index and PVE was much better characterized by a broken line than a straight line. The broken line had a steeper slope in patients with IV end-systolic volume index less than or e qual to 41 mL/m(2) than in those with > 41 mL/m(2). These findings suggest that PVE is determined mainly by IV systolic performance and partly by both IV relaxation and IV filling pressure. Left ventricular systolic performan ce may play a key role in generating a much faster PVE, especially in patie nts with relatively better IV systolic performance.