Distintas variables hemodinámicas determinan la amplitud de las ondas de llenado mitral y de las propagadas al tracto de salida

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Abstract

Objective 

To identify the physiologic variables influencing the veloci­ties of the early (E) and late (A) transmitral diastolic waves, as well as the waves transmitted to the left ventricular out­ flow tract (ETsvi y ATSVI). 

Methods 

We included 49 patients (30 women), 64±18 years of age. The following Doppler parameters were measured: veloci­ties of E, A, E_Tsvi and A_SVI' as well as the decrease of E and A velocities into the left ventricular outflow tract (ETSv/E y  sv/A). The selected diastolic function properties evaluated were: E velocity propagation (Vp), left atrial pressure  (PAI=5.27ENp+4.66), left ventricular (VI) stiffness con­stant (¾=(0.07/E deceleration time[TD])2) and end dias­tolic VI pressure (PFDVI= 46-0.22TD-0.10[2/(E/A)]), and as systolic function properties the fiber stress (SF) and a shear index unction properties the fiber stress (SF) and a shear index ([In(h₀/h)] at the beginning (c-e) and end (f-e) of the VI ejection.

Results

In the multiple regression multivariate analysis, the follow­ing variables resulted independent predictors: 1) Vp only  for E_TSVI' 2) K_VI for E, E_Tsvr, A_Tsvi and E_TSv/E, 3) PFDVI for E, A and E_TsvI' 4) [In(h₀/h)](c-e) for A_Tsvi and A_sv/A, and finally 5) [In(h₀/h)](f-e) only for A_Tsv'/A. None of the Doppler parameters appeared to depend on SF.

Conclusions

E, A and E_TSVIwaves are determined only by diastolic VI properties. On the other hand, A_TSVI depends on both systolic and diastolic variables, E_TSVI/E on diastolic ones and A_TSVI/A on systolic properties exclusively.