Acute alterations of pre- and afterload: are Doppler-derived diastolic filling patterns able to differentiate the loading condition?
| Autor: | Thomas Brüggemann, C. Spielberg, Alexander Uhrig, H. Völler, Rolf Schröder, Klaus Schröder, Hartmut von Ameln |
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| Rok vydání: | 1993 |
| Předmět: |
Adult
Male medicine.medical_specialty Diastole Hemodynamics Blood Pressure Isometric exercise Doppler echocardiography Ventricular Function Left Afterload Reference Values Internal medicine Ventricular Pressure Medicine Humans Radiology Nuclear Medicine and imaging medicine.diagnostic_test business.industry Middle Aged Myocardial Contraction Echocardiography Doppler Preload Blood pressure cardiovascular system Cardiology Ventricular pressure Female Cardiology and Cardiovascular Medicine business circulatory and respiratory physiology |
| Zdroj: | International journal of cardiac imaging. 9(4) |
| ISSN: | 0167-9899 |
| Popis: | The net effects of acute changes in pre- and afterload on left ventricular filling, were examined by altering loading conditions in normal subjects. The specific purpose of this study was to investigate whether Doppler-derived transmitral flow patterns are able to differentiate the type of loading conditions. In 24 normal subjects (13 females, 11 males, mean age 44.1 +/- 11.5 years), the following Doppler variables were determined at baseline, after rapid volume infusion (preload increase), after nitroglycerin administration (preload decrease), during isometric exercise (afterload increase), and after application of a converting enzyme inhibitor (afterload decrease): the peak and integrated early (E, Ei) and late (A, Ai) diastolic flow velocities, their ratios (E/A, Ei/Ai), the percentage of atrial contribution (ACON), and the acceleration and deceleration times (Ac, Dc) of early filling. Reduced preload and increased afterload led to similar filling patterns characterized by a significant E and Ei decrease (p0.05, compared to baseline) accompanied by an A and Ai increase with a resultant reduction of E/A and Ei/Ai. Both changes increased the atrial contribution to filling and reduced Ac and Dc. Increased preload only significantly increased E and Ei, while reduced afterload did not induce any significant changes. Different loading conditions alter Doppler-derived diastolic filling patterns. However, the transmitral flow profile is not specific enough to distinguish the manner in which loading conditions have been altered. |
| Databáze: | OpenAIRE |
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