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Diastolic time - frequency relation in the stress echo lab: filling timing and flow at different heart rates.

Bombardini T, Gemignani V, Bianchini E, Venneri L, Petersen C, Pasanisi E, Pratali L, Alonso-Rodriguez D, Pianelli M, Faita F, Giannoni M, Arpesella G, Picano E - Cardiovasc Ultrasound (2008)

Bottom Line: Diastolic filling rate was calculated as echo-measured mitral filling volume/sensor-monitored diastolic time.Diastolic time decreased during stress more markedly than systolic time.Cardiological systolic and diastolic duration can be monitored during stress by using an acceleration force sensor.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Echocardiography, Institute of Clinical Physiology, National Council of Research, Pisa, Italy. tbombardini@yahoo.it

ABSTRACT

Unlabelled: A cutaneous force-frequency relation recording system based on first heart sound amplitude vibrations has been recently validated. Second heart sound can be simultaneously recorded in order to quantify both systole and diastole duration.

Aims: 1- To assess the feasibility and extra-value of operator-independent, force sensor-based, diastolic time recording during stress.

Methods: We enrolled 161 patients referred for stress echocardiography (exercise 115, dipyridamole 40, pacing 6 patients).The sensor was fastened in the precordial region by a standard ECG electrode. The acceleration signal was converted into digital and recorded together with ECG signal. Both systolic and diastolic times were acquired continuously during stress and were displayed by plotting times vs. heart rate. Diastolic filling rate was calculated as echo-measured mitral filling volume/sensor-monitored diastolic time.

Results: Diastolic time decreased during stress more markedly than systolic time. At peak stress 62 of the 161 pts showed reversal of the systolic/diastolic ratio with the duration of systole longer than diastole. In the exercise group, at 100 bpm HR, systolic/diastolic time ratio was lower in the 17 controls (0.74 +/- 0.12) than in patients (0.86 +/- 0.10, p < 0.05 vs. controls). Diastolic filling rate increased from 101 +/- 36 (rest) to 219 +/- 92 ml/m2* s-1 at peak stress (p < 0.5 vs. rest).

Conclusion: Cardiological systolic and diastolic duration can be monitored during stress by using an acceleration force sensor. Simultaneous calculation of stroke volume allows monitoring diastolic filling rate.Stress-induced "systolic-diastolic mismatch" can be easily quantified and is associated to several cardiac diseases, possibly expanding the spectrum of information obtainable during stress.

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Exercise stress, controls vs. patients. Systolic/diastolic ratio plotted against heart rate in 17 controls (NL, left upper panel) and in patients groups during exercise stress. At each stage of exercise inter-group comparison was performed and significant differences (p < 0.05) are displayed with symbols: * = significant differences between controls and patients groups.
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Figure 10: Exercise stress, controls vs. patients. Systolic/diastolic ratio plotted against heart rate in 17 controls (NL, left upper panel) and in patients groups during exercise stress. At each stage of exercise inter-group comparison was performed and significant differences (p < 0.05) are displayed with symbols: * = significant differences between controls and patients groups.

Mentions: In the exercise group diastolic time was greater and systolic/diastolic time ratio lower in the 17 control subjects than in the 98 patients. At higher heart rates, diastole duration was blunted in patients with systemic hypertension, coronary, valvular or dilated heart disease. The relation between systole duration, diastole duration and the systolic/diastolic ratio to heart rate is demonstrated in Figure 9 and in Figure 10, showing the relative prolongation of systole and the elevated systolic/diastolic ratio in the patients at the expense of diastolic time and filling.


Diastolic time - frequency relation in the stress echo lab: filling timing and flow at different heart rates.

Bombardini T, Gemignani V, Bianchini E, Venneri L, Petersen C, Pasanisi E, Pratali L, Alonso-Rodriguez D, Pianelli M, Faita F, Giannoni M, Arpesella G, Picano E - Cardiovasc Ultrasound (2008)

Exercise stress, controls vs. patients. Systolic/diastolic ratio plotted against heart rate in 17 controls (NL, left upper panel) and in patients groups during exercise stress. At each stage of exercise inter-group comparison was performed and significant differences (p < 0.05) are displayed with symbols: * = significant differences between controls and patients groups.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2365937&req=5

Figure 10: Exercise stress, controls vs. patients. Systolic/diastolic ratio plotted against heart rate in 17 controls (NL, left upper panel) and in patients groups during exercise stress. At each stage of exercise inter-group comparison was performed and significant differences (p < 0.05) are displayed with symbols: * = significant differences between controls and patients groups.
Mentions: In the exercise group diastolic time was greater and systolic/diastolic time ratio lower in the 17 control subjects than in the 98 patients. At higher heart rates, diastole duration was blunted in patients with systemic hypertension, coronary, valvular or dilated heart disease. The relation between systole duration, diastole duration and the systolic/diastolic ratio to heart rate is demonstrated in Figure 9 and in Figure 10, showing the relative prolongation of systole and the elevated systolic/diastolic ratio in the patients at the expense of diastolic time and filling.

Bottom Line: Diastolic filling rate was calculated as echo-measured mitral filling volume/sensor-monitored diastolic time.Diastolic time decreased during stress more markedly than systolic time.Cardiological systolic and diastolic duration can be monitored during stress by using an acceleration force sensor.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Echocardiography, Institute of Clinical Physiology, National Council of Research, Pisa, Italy. tbombardini@yahoo.it

ABSTRACT

Unlabelled: A cutaneous force-frequency relation recording system based on first heart sound amplitude vibrations has been recently validated. Second heart sound can be simultaneously recorded in order to quantify both systole and diastole duration.

Aims: 1- To assess the feasibility and extra-value of operator-independent, force sensor-based, diastolic time recording during stress.

Methods: We enrolled 161 patients referred for stress echocardiography (exercise 115, dipyridamole 40, pacing 6 patients).The sensor was fastened in the precordial region by a standard ECG electrode. The acceleration signal was converted into digital and recorded together with ECG signal. Both systolic and diastolic times were acquired continuously during stress and were displayed by plotting times vs. heart rate. Diastolic filling rate was calculated as echo-measured mitral filling volume/sensor-monitored diastolic time.

Results: Diastolic time decreased during stress more markedly than systolic time. At peak stress 62 of the 161 pts showed reversal of the systolic/diastolic ratio with the duration of systole longer than diastole. In the exercise group, at 100 bpm HR, systolic/diastolic time ratio was lower in the 17 controls (0.74 +/- 0.12) than in patients (0.86 +/- 0.10, p < 0.05 vs. controls). Diastolic filling rate increased from 101 +/- 36 (rest) to 219 +/- 92 ml/m2* s-1 at peak stress (p < 0.5 vs. rest).

Conclusion: Cardiological systolic and diastolic duration can be monitored during stress by using an acceleration force sensor. Simultaneous calculation of stroke volume allows monitoring diastolic filling rate.Stress-induced "systolic-diastolic mismatch" can be easily quantified and is associated to several cardiac diseases, possibly expanding the spectrum of information obtainable during stress.

Show MeSH
Related in: MedlinePlus