PMID- 25459146
OWN - NLM
STAT- MEDLINE
DCOM- 20151124
LR  - 20150202
IS  - 1532-2777 (Electronic)
IS  - 0306-9877 (Linking)
VI  - 83
IP  - 6
DP  - 2014 Dec
TI  - Two-slope ascending arm of the early trans-mitral flow velocity Doppler wave in 
      patients with heart failure and preserved ejection fraction.
PG  - 735-9
LID - S0306-9877(14)00356-9 [pii]
LID - 10.1016/j.mehy.2014.09.030 [doi]
AB  - Trans-mitral flow velocity (TMFV) examination is a standard echocardiographic 
      measure for assessing diastolic function of the heart. Typically, the Doppler 
      signal representing the early rapid filling phase of the left ventricle (LV), 
      termed: E wave, is triangular. The ascending arm of the E wave (EWAA) represents 
      blood accelerating into the LV from the left atrium (LA), whereas the descending 
      arm reflects blood decelerating as the LV fills and resists further filling. The 
      slope of EWAA is linear, starting at TMFV of zero cm/s (prior to mitral valve 
      opening) and building to peak E wave value. The physical meaning of a single 
      slope is that blood acceleration is constant with time. Little data exist 
      regarding the significance of the shape of EWAA. It is hypothesized that in heart 
      failure with preserved ejection fraction (HFPEF) the EWAA displays 2 slopes. A 
      first steeper slope followed by a second less steep slope reaching peak E wave. 
      The different slopes represent a change in the composition of driving forces 
      propelling blood from LA to LV. It is hypothesized that the first steeper slope 
      of EWAA represents a set of driving force including a force termed: diastolic 
      suction, whereas in the second slope diastolic suction has already dissipated. 
      This 2-slope phenomenon is not expected in healthy subjects because the assumed 
      underlying mechanism is not operative.
CI  - Copyright (c) 2014 Elsevier Ltd. All rights reserved.
FAU - Dori, Guy
AU  - Dori G
AD  - Department of Internal Medicine E, HaEmek Medical Center, Afula, Israel. 
      Electronic address: guydo@clalit.org.il.
FAU - Egbaria, Muhammad A
AU  - Egbaria MA
AD  - Department of Internal Medicine E, HaEmek Medical Center, Afula, Israel.
FAU - Jabaren, Mohamed
AU  - Jabaren M
AD  - Department of Cardiology, HaEmek Medical Center, Afula, Israel.
LA  - eng
PT  - Journal Article
DEP - 20141013
PL  - United States
TA  - Med Hypotheses
JT  - Medical hypotheses
JID - 7505668
SB  - IM
MH  - Blood Flow Velocity
MH  - Cohort Studies
MH  - Diastole
MH  - *Echocardiography, Doppler
MH  - Heart Atria/physiopathology
MH  - Heart Failure/*physiopathology
MH  - Heart Ventricles/physiopathology
MH  - Humans
MH  - Linear Models
MH  - Mitral Valve/*physiopathology
MH  - Myocardium/pathology
MH  - Prevalence
MH  - Research Design
MH  - Ultrasonography
EDAT- 2014/12/03 06:00
MHDA- 2015/12/15 06:00
CRDT- 2014/12/03 06:00
PHST- 2014/07/25 00:00 [received]
PHST- 2014/09/08 00:00 [revised]
PHST- 2014/09/25 00:00 [accepted]
PHST- 2014/12/03 06:00 [entrez]
PHST- 2014/12/03 06:00 [pubmed]
PHST- 2015/12/15 06:00 [medline]
AID - S0306-9877(14)00356-9 [pii]
AID - 10.1016/j.mehy.2014.09.030 [doi]
PST - ppublish
SO  - Med Hypotheses. 2014 Dec;83(6):735-9. doi: 10.1016/j.mehy.2014.09.030. Epub 2014 
      Oct 13.