Chamber properties from transmitral flow: prediction of average and passive left ventricular diastolic stiffness

A chamber stiffness (K-LV)-transmitral flow (E-wave) deceleration time rela tion has been invasively validated in dogs with the use of average stiffnes s [(DeltaP/DeltaV)(avg)]. K-LV is equivalent to k(E), the (E-wave) stiffnes s of the parameterized diastolic filling model. Prediction and validation o f 1) (DeltaP/DeltaV)(avg) in terms of k(E), 2) early rapid- filling stiffne ss [(DeltaP/DeltaV)(E)] in terms of k(E), and 3) passive (postdiastasis) ch amber stiffness [(DeltaP/DeltaV)(PD)] from A waves in terms of the stiffnes s parameter for the Doppler A wave (k(A)) have not been achieved. Simultane ous micromanometric left ventricular (LV) pressure (LVP) and transmitral fl ow from 131 subjects were analyzed. (DeltaP)(avg) and (DeltaV)(avg) utilize d the minimum LVP-LV end-diastolic pressure interval. (DeltaP/DeltaV)(E) ut ilized DeltaP and DeltaV from minimum LVP to E-wave termination. (DeltaP/De ltaV)(PD) utilized atrial systolic DeltaP and DeltaV. E- and A-wave analysi s generated k(E) and k(A). For all subjects, noninvasive-invasive relations yielded the following equations: k(E) = 1,401.(DeltaP/DeltaV)(avg) + 59.2 (r = 0.84) and k(E) 5 229.0.(DeltaP/DeltaV)(E) + 112 (r = 0.80). For subjec ts with diastasis (n = 113), k(A) 5 1,640.(DeltaP/DeltaV)(PD) -8.40 (r = 0. 89). As predicted, k(A) showed excellent correlation with (DeltaP/DeltaV)(P D); k(E) correlated highly with (DeltaP/DeltaV)(avg). In vivo validation of average, early, and passive chamber stiffness facilitates quantitative, no ninvasive diastolic function assessment from transmitral flow.