Echocardiographic particle image velocimetry (E-PIV) is a tool that tracks contrast for the characterization of the intraventricular vortex formed throughout the cardiac cycle. E-PIV elicits information on vortical geometry, dynamicity, and efficiency [sphericity index (SI), vortex pulsatility coefficient (VPC) and vortex strength (VS), respectively]. These indices, which could provide unique pathophysiologic insight, have not been well studied in heart failure with preserved ejection fraction (HFpEF). Furthermore, E-PIV indices have not previously been correlated with gold standard invasive measures of left ventricular [LV] diastolic function (i.e., LV relaxation and compliance). We will prospectively study 25 patients with varying degrees of “garden variety” HFpEF (i.e., HFpEF associated with hypertension, obesity, diabetes/metabolic syndrome and/or chronic kidney disease) and 5 age-, sex- and comorbidity-matched controls without HF. Participants will undergo both comprehensive echocardiography (including E-PIV) and right/left heart catheterization (RLHC) using micromanometer catheters for measurement of E-PIV indices, tau, and single-beat LV diastolic pressure-volume relations at rest and during graded exercise. Specific Aim 1: Characterize LV vortex in HFpEF and controls at rest and exercise. Hypothesis 1:The vortex will be more elongated (greater SI), more dynamic (greater VPC), and less efficient (lower VS) in HFpEF compared to controls, and these abnormalities will correlate with severity of HFpEF. Specific Aim 2: Characterize the relationship between PIV variables, LV relaxation (tau), and LV diastolic compliance in HFpEF. Hypothesis 2: A more elongated (greater SI), more dynamic (greater VPC), and less efficient (lower VS) vortex are associated with prolonged tau and decreased LV compliance in HFpEF.
|Effective start/end date||7/1/14 → 6/30/15|
- Heart Failure Society of America, Inc. (AGMT-6/11/15)
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