The contribution of atrial systole to mitral diastolic blood flow increases during exercise in humans.

Channer, Kevin S.; Jones, J V

doi:10.1113/jphysiol.1989.sp017559

Cited by 19 publications

(7 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Previous studies in humans have demonstrated that the percentage of second-half filling volume increases during supine bicycle exercise (Carroll, Hess, Hirzel & Krayenbuehl, 1983). Additional recent studies with Doppler recordings of transmitral blood flow velocity in normal subjects suggest that the contribution of atrial systole to overall transmitral blood flow progressively increases during mild exercise (Channer & Jones, 1989).…”

Section: Increased Booster Function During Exercisementioning

confidence: 92%

“…Early studies have shown that when atrial fibrillation is converted to sinus rhythm, with little change in ventricular heart rate, there is still a measurable difference in cardiac output, especially during exercise (Hecht, Osher & Samuels, 1951) (Carroll, Hess, Hirzel & Krayenbuehl, 1983). Additional recent studies with Doppler recordings of transmitral blood flow velocity in normal subjects suggest that the contribution of atrial systole to overall transmitral blood flow progressively increases during mild exercise (Channer & Jones, 1989 (Rahimtoola et al 1975), or myocardial hypertrophy (Hanrath, Mathey, Siegert & Bleifeld, 1980 Mechanisms for increased atrial booster function Linden & Mitchell (1960) have shown in anaesthetized open-chest dogs that when LV end-diastolic pressure wVas low, atrial systole caused greater changes in LV fibre length than when LV end-diastolic pressure was high. Doppler echocardiographic measurements have shown the ratio of passive to active transmitral blood flow velocity to be directly related to LV preload (Stoddard, Pearson, Kern, Ratcliff, Arosek & Labovitz, 1989).…”

Section: Increased Booster Function During Exercisementioning

confidence: 96%

See 1 more Smart Citation

Effect of dynamic exercise on left atrial function in conscious dogs.

Nishikawa

Roberts

Tan

et al. 1994

The Journal of Physiology

View full text Add to dashboard Cite

1. Dynamic changes in left atrial (LA) function during treadmill exercise were studied in ten conscious dogs instrumented to measure left ventricular (LV) pressure and diameter, LA pressure and diameter, and pulmonary venous blood flow (PVF, transit time flowmeter). 2. Systolic PVF volume (reservoir volume; a measure of LA reservoir function) increased from 38 + 4% of total PVF volume at baseline to 52 + 8% of total PVF volume during exercise, and diastolic PVF volume (conduit volume; a measure of LA conduit function) decreased from 62 + 5 % at baseline to 48 + 8 % during exercise (P < 0 005). 3. The increases in reservoir volume and the decrease in conduit volume were due not only to a greater decrease in diastolic interval than systolic interval but were also caused by a significantly greater increase (P < 0 05) in the mean systolic filling rate (93 %) than in the mean diastolic filling rate (51%).4. During exercise the pattern of LV filling derived from changes in LV diameter showed that a greater percentage of LV filling occurred during the second half of diastole at the time of atrial contraction (P < 0 05), suggesting that LA booster function was enhanced. 5. Changes in LA dimension revealed that during exercise more blood volume was reserved in the LA during systole and that this change was associated with an increase in the LA dimension at the beginning of LA contraction (r = 0-61, P < 005). 6. We conclude that LA reservoir and booster functions were augmented during exercise, whereas conduit function was not. Increased reservoir function may play an important role in accelerating LV filling by helping to maintain an enhanced atrioventricular pressure gradient during diastole and also by increasing LA booster function through an increase in LA preload.

show abstract

Section: Increased Booster Function During Exercisementioning

confidence: 92%

Section: Increased Booster Function During Exercisementioning

confidence: 96%

Effect of dynamic exercise on left atrial function in conscious dogs.

Nishikawa

Roberts

Tan

et al. 1994

The Journal of Physiology

View full text Add to dashboard Cite

show abstract

“…Several previous studies conducted in vivo have reported a physiological reduction in E/A with increasing HR in healthy subjects (Iliceto et al, 1991; Swinne et al, 1992; Yamamoto et al, 1993). Increasing HR has been correlated to increased atrial systolic velocity (Channer and Jones, 1989; Harrison et al, 1991; Mitchell et al, 1965; Ruskin et al, 1970). However, the functional implication of the elevated role of atrial systole during LV filling under increasing HR is unclear.…”

Section: Discussionmentioning

confidence: 99%

Atrial systole enhances intraventricular filling flow propagation during increasing heart rate

Santhanakrishnan

Okafor

Kumar

et al. 2016

Journal of Biomechanics

View full text Add to dashboard Cite

Diastolic fluid dynamics in the left ventricle (LV) has been examined in multiple clinical studies for understanding cardiac function in healthy humans and developing diagnostic measures in disease conditions. The question of how intraventricular filling vortex flow pattern is affected by increasing heart rate (HR) is still unanswered. Previous studies on healthy subjects have shown a correlation between increasing HR and diminished E/A ratio of transmitral peak velocities during early filling (E-wave) to atrial systole (A-wave). We hypothesize that with increasing HR under constant E/A ratio, E-wave contribution to intraventricular vortex propagation is diminished. A physiologic in vitro flow phantom consisting of a LV physical model was used for this study. HR was varied across 70, 100 and 120 beats per minute (bpm) with E/A of 1.1–1.2. Intraventricular flow patterns were characterized using 2D particle image velocimetry measured across three parallel longitudinal (apical-basal) planes in the LV. A pair of counter-rotating vortices was observed during E-wave across all HRs. With increasing HR, diminished vortex propagation occurred during E-wave and atrial systole was found to amplify secondary vorticity production. The diastolic time point where peak vortex circulation occurred was delayed with increasing HR, with peak circulation for 120 bpm occurring as late as 90% into diastole near the end of A-wave. The role of atrial systole is elevated for higher HR due to the limited time available for filling. Our baseline findings and analysis approach can be applied to studies of clinical conditions where impaired exercise tolerance is observed.

show abstract

“…Our patients with CAD had similar filling characteristics at baseline to controls. Despite the results that may indicate normal or near normal diastolic function, the pseudonormalized pattern caused by the coexistence of approximately equally important abnormalities of chamber stiffness and relaxation may have effected the initial results [17,39,42].…”

Section: Discussionmentioning

confidence: 99%

Transmitral pulsed‐Doppler echocardiography is a more accurate technique compared with two‐dimensional echocardiography using dobutamine, in patients with one vessel coronary artery disease

Bajraktari

Qirko

Fusco

et al. 2003

European J of Heart Fail

View full text Add to dashboard Cite

To examine the effects of dobutamine on pulsed‐Doppler left ventricular filling indices and its utility for evaluation of CAD we studied 14 patients with normal coronary arteries (Group 1) and 39 patients with significant CAD (>70% diameter stenosis). Patients with coronary artery disease (CAD) were divided into two groups: patients with one‐vessel coronary disease (Group 2); and those with multivessel CAD (Group 3). After stopping cardioactive treatment, patients underwent incremental dobutamine stress (5, 10, 20, 30 and 40 μg/kg/min) during pulsed‐Doppler interrogation of diastolic filling with simultaneous heart rate and blood pressure measurements. The following transmitral Doppler variables were measured at baseline and at peak‐dose of dobutamine: peak early (E) and peak atrial (A) velocity; E/A ratio; acceleration time (AT) and deceleration time (DT) of E wave; isovolumic relaxation time (IVRT); and time–velocity integral (TVI). Two‐dimensional echocardiography was performed to detect regional asinergy and analyzed using a 16 segment model. Results: Normals and CAD patients showed comparable changes in heart rate and blood pressure (P=NS between groups). Intergroup analysis of the changes of transmitral flow showed the significant changes for these indices (P<0.001): E velocity (−2.78±10.04, 12.4±9.4 and 16.47±10.65 cm/s); AT of E wave (1.66±2.47, −5.2±1.38 and −4.66±2.39 m/s2); DT of E wave (−0.23±0.18, 0.2±0.2 and 0.2±0.28 m/s2); and TVI of transmitral flow (−1.26±0.7, 3.5±1.75 and 4.1±1.66 cm), respectively for Groups 1, 2 and 3. All other transmitral Doppler variables showed insignificant changes (P=NS) to dobutamine between groups. It is important that the significance of these changes were the same for patients with one‐vessel and those with multivessel coronary disease. In conclusion, during dobutamine stress testing, patients with CAD, had an abnormal response of these transmitral Doppler indices: E wave; AT of E wave; DT of E wave; and the TVI of transmitral flow. The abnormal responses of these Doppler indices of left ventricular filling are more accurate markers of significant single vessel CAD than new wall motion abnormalities during conventional DSE.

show abstract

The contribution of atrial systole to mitral diastolic blood flow increases during exercise in humans.

Cited by 19 publications

References 18 publications

Effect of dynamic exercise on left atrial function in conscious dogs.

Effect of dynamic exercise on left atrial function in conscious dogs.

Atrial systole enhances intraventricular filling flow propagation during increasing heart rate

Transmitral pulsed‐Doppler echocardiography is a more accurate technique compared with two‐dimensional echocardiography using dobutamine, in patients with one vessel coronary artery disease

Contact Info

Product

Resources

About