Key result
EA-fusion pattern links to higher E and E' velocities versus EA-separation in hypertensive rats.
Why the study?
It was hypothesized that intraventricular pressure gradients and E/E’ are differentially influenced by trans-mitral inflow patterns.
Does the trans-mitral flow pattern (EA-fusion vs EA-separation) affect intraventricular pressure gradients and E/E' in a rat model of hypertensive cardiomyopathy?
Does the trans-mitral flow pattern (EA-fusion vs EA-separation) affect intraventricular pressure gradients and E/E' in a rat model of hypertensive cardiomyopathy?
Absolute Event Rate: 1.04% vs 0.91%
p-value: p=<0.001
In a rat model of hypertensive cardiomyopathy, mitral inflow patterns significantly affect E/E' and basal intraventricular pressure gradients, highlighting the need to account for heart rate-induced EA-fusion when evaluating diastolic function.
May confound E/E' assessment in hypertensive cardiomyopathy models; hypothesis-generating for diastolic evaluation and requires human translation.
Background The mitral inflow spectral is expressed as two separate waves: early diastolic trans-mitral flow velocity (E) and late diastolic trans-mitral flow velocity (A) waves. When the heart rate (HR) increases and the diastolic time diminishes, the mitral flow pattern changes from EA-separation to EA-fusion. The E wave provides information about preload and diastolic function. Tissue Doppler imaging (TDI) and non-invasive intraventricular pressure gradient (IVPG) based on color-M-mode echocardiography are two techniques established in recent years with good repeatability in cardiac function evaluation, especially diastolic. Hypothesis/objective We hypothesize that IVPG and E/E’ are differentially influenced by mitral inflow patterns. Animals A total of 66 hypertensive cardiomyopathy (HTN-CM) induced by abdominal aorta coarctation and 33 sham-operated rats were divided into 6 groups according to trans-mitral flow patterns. Methods Conventional echocardiography, TDI, and IVPG sampling were performed on rats under general anesthesia with 2.5% isoflurane at 3 weeks after the operation. After code EA-separation = 1, EA-half-separation = 2, and EA-fusion = 3, Pearson’s correlation tests were performed. Results Both E and E’ in EA-fusion (1.04 ± 0.13 and 7.65 ± 0.84) are higher than the EA-separation pattern in all rats (0.91 ± 0.10 and 5.51 ± 0.78, p < 0.001). The preload change has more impact on E’ than E (0.443 vs. 0.218, p < 0.001, respectively), which leads to decreased E/E’ in EA-fusion. Total IVPG and basal IVPG positively correlated with the mitral inflow pattern (0.265 and 0.270, p < 0.001), while mid-to-apical IVPG was not (0.070, p = 0.281). Conclusion The mitral inflow pattern positively correlates with basal IVPG, E, and E’. Mid-to-apical IVPG was independent of mitral inflow patterns, while E/E’ tended to be lower when the mitral inflow pattern changed from EA-separation to EA-fusion.
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Hirose et al. (2025) studied Hypertensive cardiomyopathy (n=99). EA-fusion mitral inflow pattern vs. EA-separation mitral inflow pattern was evaluated on Early diastolic trans-mitral flow velocity (E) (p=<0.001). In a rat model of hypertensive cardiomyopathy, the EA-fusion mitral inflow pattern was associated with significantly higher E and E' velocities compared to the EA-separation pattern.
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