Isovolumic relaxation intraventricular pressure difference predicts elevated left ventricular end-diastolic pressure in patients with coronary artery disease

Figures

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  Fig. 1. The relative intraventricular pressure mapping and the measurement of IVPD. Apical 3 chamber view was used to calculate IVPDs, with the help of color doppler and speckle tracking of LV, in a patient from normal group and CAD group (A to C and D to F, respectively). The relative intraventricular pressure mapping of LV showed a high to low gradient from the base to apex of LV at the beginning of diastole (isovolumic relaxation period) in both patients (B, E). The IVPD was measured as the pressure difference between the LVOT and LV, indicated as the dotted yellow lines (C, F). Note the relative pressure difference was more significant (shown as deeper red and blue) in the normal control (B) than the CAD patient (E). The apical-mid IVPD contributed more to the proportional reduction of total IVPD, as this percentage was higher in control (C) than in CAD patient (F) in the isovolumic relaxation period.

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  Fig. 2. The simultaneous IVPD and electrocardiogram (ECG) waveform of a complete cardiac cycle was recorded from a normal subject (A) and a CAD patient (B). In each period, a peak intraventricular pressure difference was generated. IVC, isovolumic contraction period (mitral close - aortic open); RE, rapid ejection period (aortic open); IVR, isovolumic relaxation period (aortic close - mitral open); RF, rapid filling period (mitral open); AC, atrial contraction period (mitral open).

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  Fig. 3. Correlation analyses of echocardiographic parameters and LVEDP. IVR, isovolumic relaxation period; For other abbreviations, see Table 1.

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  Fig. 4. Receiver operating characteristics (ROC) curves for prediction of elevated LVEDP. AUC, area under the ROC curve. For abbreviations, see Table 1.

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  Fig. 5. Bland-Altman analysis for intra- and inter-observer variabilities for IVPDs. For abbreviations, see Table 1.