Pressure-Flow Studies in Hypertrophic Subaortic Stenosis *

Hernández, Rafael Rivas; Greenfield, Joseph C.; McCall, Benjamin W.

doi:10.1172/jci104924

Cited by 108 publications

(17 citation statements)

References 18 publications

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“…Previous studies of the dynamics of ascending aortic flow in the presence of "outflow obstruction" have shown that almost all of the left ventricle's stroke volume is ejected in the first 50-60% ofsystole (15,16). Pierce et al (15) concluded that ejection was diminished in late systole because of a mechanical obstruction to left ventricular outflow, whereas Hemandez et al (16) explained that the same phenomenon could have been secondary to a rapid and powerful ventricular contraction which resulted in an earlier completion of ejection.…”

Section: Introductionmentioning

confidence: 99%

“…Pierce et al (15) concluded that ejection was diminished in late systole because of a mechanical obstruction to left ventricular outflow, whereas Hemandez et al (16) explained that the same phenomenon could have been secondary to a rapid and powerful ventricular contraction which resulted in an earlier completion of ejection. The former mechanism implies that left ventricular outflow is impeded during mid-and late systole, whereas the latter does not.…”

Section: Introductionmentioning

confidence: 99%

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Dynamics of left ventricular ejection in obstructive and nonobstructive hypertrophic cardiomyopathy.

Murgo¹,

et al. 1980

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A B S T R A C T The purpose of this study was to examine the dynamics of left ventricular ejection in patients with obstructive and nonobstructive hypertrophic cardiomyopathy (HCM). 30 patients with HCM and 29 patients with no evidence of cardiovascular disease were studied during cardiac catheterization. Using a single multisensor catheter, electromagnetically derived ascending aortic flow velocity and high fidelity left ventricular and aortic pressures were recorded during rest (tl = 47) and provocative maneuvers (it = 23). Dynamic ventricular emptying during rest was also analyzed with frame-by-frame angiography (n = 46). Left ventricular outflow was independently derived from both flow velocity and angiographic techniques. The HCM patients were subdivided into three groups: (I) intraventricular gradients at rest (n = 9), (II) intraventricular gradients only with provocation (n = 12), and (III) no intraventricular gradients despite provocation (n = 9). During rest, the percentage of the total systolic ejection period during which forward aortic flow existed was as follows (mean+ 1 SD): group I, 69+17% (flowv), 64±6% (angio); group II, 63 +14% (flow), 65±+6% (angio); group III, 61+16% (flow), 62±+4% (angio); control group, 90±o5% (flow), 86±+9% (angio). No significant difference was observed between any of the HCM subgroups, but compared with the control group, ejection was completed much earlier in systole independent of the

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Dynamics of left ventricular ejection in obstructive and nonobstructive hypertrophic cardiomyopathy.

Murgo¹,

et al. 1980

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“…The technique has been experimentally evaluated in both a flow generator (3) and in the dog aorta (4) and found to yield a valid estimate of phasic flow. The technique has been applied sucessfully in this laboratory (5,6) and by other investigators (7)(8)(9) to measure pulsatile blood pressure and flow in the ascending aorta of the intact human subject. The instrumental techniques, manometric accuracy requirements, and calibration procedures used in our laboratory to obtain valid phasic flow and pressure data in man have been previously described in detail and will only be reviewed briefly (10,11).…”

Section: Introductionmentioning

confidence: 99%

Pressure-flow studies in man during atrial fibrillation

Greenfield¹,

Harley²,

Thompson³

et al. 1968

J. Clin. Invest.

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A B S T R A C T In 13 patients who had atrial fibrillation the ascending aortic pressure-flow relationships were measured by the pressure gradient technique. Both the pressure and flow curves were similar in contour to ones previously obtained by this method. From these recordings, relationships between the phases of systole, the ventricular filling time, and various derived parameters of pressure and flow such as the pulse pressure, stroke volume, peak flow, stroke work, and peak power were evaluated. For stroke volumes greater than 15 cm3 there was little change in the duration of systole in an individual patient. In each patient both the preejection period and the duration of ejection showed a good correlation with stroke volume, peak flow, stroke work, and peak power. When data from all patients were examined, the relationship between stroke volume and duration of ejection was found to be curvilinear and had an overall correlation of r = 0.91. There was marked variation from patient to patient in duration of both the preejection period and systole. Similar correlations between the phases of systole were noted with peak flow, peak power, and stroke work. A positive but mediocre correlation was found between the previous RR interval (an index of ventricular filling time) and the subsequent stroke volume. The correlation, in six patients, between two previous RR intervals and stroke volume was considerably better. The relationship between the pulse pressure and stroke volume was reasonably close except in one patient; however, the group correlation was poor due to differences between individuals.

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“…By frame-by-frame analysis of cineangiograms"' 3 ' 51 , by the measurement of aortic flow by means of an electromagnetic flowmeter cuffed around the ascending aorta at the time of operation' 2 ' 8 ', by means of a catheter-mounted velocity-probe placed in the ascending aorta' 3 ', or by application of the pressure-gradient technique to pressure measurements in the ascending aorta' 7 ', it has been shown that in HOCM aortic flow velocity is abnormally high in early systole. After the early peak of aortic flow a sharp drop to a lower plateau with little' 2 -7 ' 81 or no further ejection"' 3 ' 41 into the ascending aorta was described.…”

Section: Discussionmentioning

confidence: 99%