Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “DECELERATION”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 811 records · Page 45Linked to original sources
PubMed2003

Information used in detecting upcoming collision.

In four experiments we examined the nature of the information used in judging whether events would or would not give rise to a collision in the near future. Observers were tested in situations depicting approaches between two objects (lateral approaches) and approaches between an object and the point of observation (head-on approaches), with objects moving according to constant deceleration or sinusoidal deceleration patterns. Judgments were found to be based, to a large extent, on the (in)sufficiency of current deceleration to avoid upcoming collision, as specified optically by tau-dot (tau). However, the information specified by tau (tau), that is the current (first-order) time remaining until contact, was also found to play a significant role. We deduce that judgment of upcoming collision is based on the detection of tau and its evolution over time, suggesting that observers are sensitive to delta(tau) rather than to tau itself.

Acceleration↗
PubMed2005

Determination of maximum leaf velocity and acceleration of a dynamic multileaf collimator: implications for 4D radiotherapy.

The dynamic multileaf collimator (MLC) can be used for four-dimensional (4D), or tumor tracking radiotherapy. However, the leaf velocity and acceleration limitations become a crucial factor as the MLC leaves need to respond in near real time to the incoming respiration signal. The aims of this paper are to measure maximum leaf velocity, acceleration, and deceleration to obtain the mechanical response times for the MLC, and determine whether the MLC is suitable for 4D radiotherapy. MLC leaf sequence files, requiring the leaves to reach maximum acceleration and velocity during motion, were written. The leaf positions were recorded every 50 ms, from which the maximum leaf velocity, acceleration, and deceleration were derived. The dependence on the velocity and acceleration of the following variables were studied: leaf banks, inner and outer leaves, MLC-MLC variations, gravity, friction, and the stability of measurements over time. Measurement results show that the two leaf banks of a MLC behave similarly, while the inner and outer leaves have significantly different maximum leaf velocities. The MLC-MLC variations and the dependence of gravity on maximum leaf velocity are statistically significant. The average maximum leaf velocity at the isocenter plane of the MLC ranged from 3.3 to 3.9 cm/s. The acceleration and deceleration at the isocenter plane of the MLC ranged from 50 to 69 cm/s2 and 46 to 52 cm/s2, respectively. Interleaf friction had a negligible effect on the results, and the MLC parameters remained stable with time. Equations of motion were derived to determine the ability of the MLC response to fluoroscopymeasured diaphragm motion. Given the present MLC mechanical characteristics, 4D radiotherapy is feasible for up to 97% of respiratory motion. For the largest respiratory motion velocities observed, beam delivery should be temporarily stopped (beam hold).

Algorithms↗
PubMedDate not supplied

An electromyographic analysis of the shoulder during a medicine ball rehabilitation program.

We used dynamic electromyography and a motion analysis system to describe the muscle firing patterns in 10 shoulder muscles and the basic kinematics of a two-handed overhead medicine ball throw. Ten healthy male subjects with no history of shoulder injury were evaluated. The two-handed medicine ball throw was divided into three phases for analysis: cocking, acceleration, and deceleration. The average duration of the throw was 1.92 seconds; the cocking phase represented 56%, the acceleration phase 15.5%, and the deceleration phase 28.5% of the throw. In the cocking phase, the upper trapezius, pectoralis major, and anterior deltoid muscles showed high activity ( > 40% to 60% maximum manual test), and the rotator cuff muscles had moderate activity ( > 20% to 40%). In the acceleration phase, five of the muscles demonstrated high levels of activity ( > 40% to 60%) and the upper trapezius and lower subscapularis muscles had very high levels of activity ( > 60%). Analysis of the deceleration phase revealed high activity in the upper trapezius muscle and moderate activity in all other muscles except the pectoralis major. Our findings support the use of medicine ball training as a bridge between static resistive training and dynamic throwing in the rehabilitation of the overhead athlete. This training technique provides a protective method of strengthening that closely simulates portions of the throwing motion.

Acceleration↗
PubMed1994

Causes and formation of cavitation in mechanical heart valves.

Cavitation may develop on mechanical valvular prostheses in the mitral position; it causes blood damage and, under particularly adverse conditions, it may result in sudden failure of the prosthesis. Therefore, with regard to future development of mechanical heart valves, the pattern of cavitation and its predisposing factors in different types of prostheses were investigated in in vitro studies, which focused on the analysis of valve closure dynamics and the influence of design parameters on the cavitation-inducing pressure drop at the artificial valve. It was found that cavitation is produced primarily by the deceleration of the closing body of the valve. At 900g, the measured deceleration of the closing bodies falls in the range of the decelerations determined in oscillation experiments for investigating cavitation-induced material erosion. The pressure drop produced thereby is overlapped by the pressure drop in accelerated or turbulent flow regions produced by design characteristics at outlet struts, stop faces or sealing lips during backflow through the closing disc. These phenomena exist particularly in regions of high flow velocity, i.e. at the instant of closure at the maximum distance from the bearing axis of the closing body (12 o'clock position). The onset of cavitation is additionally promoted in this position by a tight joint between the closing body and the ring. Oscillations of the closing body generally have a negligible effect on the cavitation behavior. From these relationships one can infer that cavitation can be avoided in future in mechanical heart valves by locally limited design measures. Especially, unsteadiness in the backflow through the closing valve is to be avoided.

Acceleration↗
PubMed1995

[The perinatal risk factors of periventricular leukomalacia (PVL) in premature infants].

Periventricular leukomalacia (PVL) has recently been recognized as an important risk factor in neurological impairment of the premature infant. We studied 29 PVL cases concerning perinatal risk factors retrospectively comparing them with a non-PVL matched control group. Variable decelerations were more frequently observed with statistical significance in the PVL group in the intrapartum period. There was no significant difference between the two groups in the appearance of late deceleration. A lower incidence of RDS, a higher incidence of low Apgar score, a longer period of ventilation and oxygen inhalation and a more persistent presence of apneic spells were documented in the PVL group with statistical significance. Our study suggests the significance of variable deceleration as a risk factor in the occurrence of PVL in premature infants as well as other previously documented risk factors.

Apgar Score↗
PubMed1993

The pattern of growth failure in Rett syndrome.

OBJECTIVE: To define the growth pattern of girls with Rett syndrome with respect to height, weight, and fronto-occipital head circumference. DESIGN: Longitudinal with irregular intervals between measurements. SETTING: Rett Syndrome Program Project at Baylor College of Medicine, Houston, Tex. PARTICIPANTS: Ninety-six girls fulfilling criteria for Rett syndrome; comparison group with standard growth curves. SELECTION PROCEDURE: Consecutive entries into the Rett Syndrome Program Project. INTERVENTION: None. MEASUREMENTS/MAIN RESULTS: Height, weight, and fronto-occipital head circumference data were grouped into intervals. Group medians were then generated. Regression lines were fitted through the median points and plotted on standard growth charts. Deceleration of growth velocities began at age 3 months and persisted through age 18 years. CONCLUSIONS: Early deceleration of head growth, followed by deceleration of weight and height measurements, appears to be a growth pattern characteristic of Rett syndrome. This pattern of growth may provide the earliest clinical indicator for the diagnosis of Rett syndrome.

Adolescent↗
PubMed1999

A novel scheme for the time-of-flight analysis of extended ion packets

A new scheme is proposed for providing enhanced time-of-flight focusing of spatially extended ion packets moving with close to uniform velocity, sufficiently high for reliable ion detection. The arrangement consists of two decelerating regions with homogeneous electric fields similar to the two-stage ion reflector. The decelerating field in the first decelerating stage is created in a pulsed fashion after the ion packet has entered the first region. The effect of fringe fields produced by shielding rings and the microchannel plate detector is discussed. Copyright 1999 John Wiley & Sons, Ltd.

Journal Article↗
PubMed1998

Analysis of heat generation during rotational atherectomy using different operational techniques.

Rotational atherectomy can generate heat from the friction of the burr as it ablates atherosclerotic plaque. The objective of this study is to correlate Rotablator technique and heat generation using two experimental models. First, 2.0 mm burrs were advanced through a lesion model derived from bovine bone implanted with thermal probes. Intermittent ablation with minimal decelerations resulted in a smaller temperature increase than continuous ablation with maximal decelerations (2.6 +/- 1.3 vs. 13.9 +/- 1.0 degrees C, respectively, P < 0.01). The second model used porcine femoral arteries cradled in constricting polyethylene grafts with thermal probes in contact with the adventitia. As the burr advanced through the segment, RPM decreases of 5-7 k resulted in a temperature rise of 4.1 +/- 1.2 degrees C, whereas decelerations of 10-20 k resulted in a 11.3 +/- 6.2 degrees C temperature increase. We conclude that excessive drops in speed and aggressive advancement of the burr are related to significant increases in temperature and potential thermal injury.

Animals↗
PubMedDate not supplied

Intrapartum fetal asphyxial brain injury with absent multiorgan system dysfunction.

Current understanding of the physiologic mechanisms of intrapartum fetal asphyxial brain injury has suggested a strong association with multiorgan system injury. Thus the purpose here is to describe 14 cases of severe fetal brain injury with absent multiorgan system dysfunction (MSD). The study population was drawn from a national registry for brain injured infants. MSD was defined by clinical criteria demonstrated to reflect asphyxial injury to the pulmonary, renal, cardiac, hematologic, hepatic, and gastrointestinal systems. Involvement of one other organ in addition to the brain was defined as multiorgan system dysfunction. All infants were diagnosed with hypoxic-ischemic encephalopathy (HIE) in the neonatal period and went on to have permanent central nervous system (CNS) injury and MSD criteria were not met. Of the 292 term, singleton infants with HIE and permanent neurologic injury, 57 (20%) satisfied the entry criteria; of these, 14 (36%) had no MSD. The underlying basis for the fetal brain injury were: uterine rupture, 6 (43%), prolonged FHR deceleration, 5 (36%), fetal exsanguination, 1 (7%), cord prolapse, 1 (7%), and maternal cardiopulmonary arrest, 1 (7%). The mean duration of the prolonged FHR deceleration was 32.1 +/- 9.1 (range 19-51) minutes. All infants were later diagnosed with cerebral palsy. Intrapartum fetal asphyxial brain injury may not necessarily proceed through a physiologic mechanism in which the fetal circulation is centralized and endorgans damaged. These acute injuries, associated with a prolonged FHR deceleration, may be linked to severely decreased cardiac output and hypotension that cause vulnerable portions of the brain to be injured before other organs.

Asphyxia Neonatorum↗
PubMed2000

Prophylactic versus therapeutic amnioinfusion for oligohydramnios in labour.

BACKGROUND: Amnioinfusion aims to relieve umbilical cord compression during labour by infusing a liquid into the uterine cavity. OBJECTIVES: The objective of this review was to assess the effects of prophylactic amnioinfusion for oligohydramnios compared with therapeutic amnioinfusion only if fetal heart rate decelerations or thick meconium-staining of the liquor occur. SEARCH STRATEGY: The Cochrane Pregnancy and Childbirth Group trials register and Cochrane Controlled Trials Register were searched. Date of last search: October 1997. SELECTION CRITERIA: Randomised trials comparing prophylactic with therapeutic amnioinfusion in women with oligohydramnios but not fetal heart rate deceleration in labour. DATA COLLECTION AND ANALYSIS: The reviewer assessed trial quality and extracted data. MAIN RESULTS: Two studies of 285 women were included. No differences were found in the rate of caesarean section (relative risk 0.98, 95% confidence interval 0.58 to 1.66), or forceps delivery. There were no difference in Apgar scores, cord arterial pH, oxytocin augmentation, meconium aspiration, neonatal pneumonia or postpartum endometritis. Prophylactic amnioinfusion was associated with increased intrapartum fever (relative risk 3.48, 95% confidence interval 1.21 to 10.05). REVIEWER'S CONCLUSIONS: There appears to be no advantage of prophylactic amnioinfusion over therapeutic amnioinfusion carried out only when fetal heart rate decelerations or thick meconium-staining of the liquor occur.

Amnion↗
PubMed1994

The effect of viewing the static hand prior to movement onset on pointing kinematics and variability.

Pointing accuracy and arm movement kinematics of six human subjects were measured in three conditions where the hand was never visible during the ongoing movement: (1) in the dark; (2) the static hand was seen in peripheral vision prior to target presentation, but not during the reaction time (H-T); (3) the static hand was seen in peripheral vision until movement onset (H+T). It was shown that: (1) viewing the hand prior to movement decreased pointing variability as compared to the dark condition. (2) Viewing simultaneously hand and target (H+T) and further decreased pointing variability as compared to the H-T condition. This effect was proportional to the reaction time. (3) A lengthening of the deceleration phase was observed for movements performed in the H+T condition, as compared to the other two conditions. (4) A negative correlation between variability and the first part of the deceleration phase was observed in the H+T condition, but neither in the H-T condition nor in the dark. These results suggest that the decrease in pointing variability observed in the H+T condition is due to a feedback based on kinesthetic reafference. Better encoding of the initial position of the hand relative to the target (as in H+T) would allow a calibration of arm position sense, which is used to drive the hand toward the target during the deceleration phase.

Adult↗
PubMed2000

Drug injection rates and needle-exchange use in New York City, 1991-1996.

Objectives included (1) to develop methods for identifying injection drug users with accelerating injection habits so they might be referred to counseling and treatment and (2) to investigate behavioral correlates of accelerating injection habits, including syringe-exchange program utilization. Data on drug use, enrollment in methadone maintenance, and demographic variables were obtained from 328 subjects who were seronegative for human immunodeficiency virus (HIV) who attended anywhere from 4 to 11 quarterly study visits for interview, HIV pretest counseling and risk reduction counseling, and blood donation for HIV antibody testing. Subjects were recalled 2 weeks after each study visit to receive their results and post-test counseling. We characterized subjects according to their patterns of drug injection as accelerating, decelerating, or stable, using intraindividual regression analyses and categorization rules, and by syringe-exchange use as consistent users, sporadic users, or nonusers. The present subjects included 52% with decelerating, 29% with stable, and 19% with accelerating rates of drug injection. There were 128 subjects (39%) who were categorized as consistent users of syringe-exchange programs, 84 (25%) were categorized as sporadic users, and 116 (35%) were categorized as nonusers. All syringe-exchange groups showed significantly decelerating drug injection. Rates of decline were significantly less, however, among consistent syringe-exchange users than sporadic or nonusers of syringe exchanges. Categorical analysis also showed significant differences among groups, with 30% of consistent syringe-exchange program users having accelerating rates of drug injection compared to 9% of nonusers and 17% of sporadic users. That consistent syringe-exchange users included a larger proportion of individuals whose drug habits were accelerating than did sporadic users or nonusers of syringe exchanges suggests a need for improved identification and counseling of such subjects by syringe-exchange program staff. The present statistical approaches may be of value in targeting such efforts. The ability of a syringe-exchange program to attract a disproportionate share of drug users with accelerating rates of drug injection underscores the importance of these programs to HIV prevention efforts.

Adult↗
PubMedDate not supplied

Heart-rate responses (HRR) to lateralized visual stimuli.

Direction of changes in heart-rate responses (HRR) were investigated in three separate experiments as a measure of differential cognitive and emotional specialization of the cerebral hemispheres. Visual stimuli were presented via the visual half-field technique in all three experiments. Slides with different contents were flashed for 200 msec on each trial either to the left or right of a center LED fixation point. The LED went on 5 seconds prior to slide onset. HR changes were scored as second-by-second deviations during 10 seconds after LED onset from pre-LED base line. In the first experiment it was hypothesized that emotionally relevant stimuli initially projected to only the right hemisphere would result in more anticipatory acceleration than when the same stimulus was initially projected to the left hemisphere. A picture of a snake and of a geometric figure were repeatedly briefly flashed to the right of the LED for half of the subjects, and to the left for the other half. There were 25 trials with an intertrial interval of 25-40 seconds. Results showed significant effects of deceleration as a function of the slide stimulus in all groups on seconds 5, 6, or 7 after onset of the center LED. Furthermore, an anticipatory acceleration was observed during the first trial-block on seconds 3 and 4 in the right hemisphere groups only with no differences between the neutral and emotional stimuli. In Experiments 2 and 3, a letter-string of six letters and a complex symmetric pattern were used as stimuli. These stimuli were chosen because previous research has clearly implicated the hemispheres to be differentially specialized in their ability to process verbal and visuo-spatial stimuli. The set-up was identical to Experiment 1, with the exception that differences in response to the two types of stimuli were evaluated on a within-subjects basis. The results from Experiments 2 and 3 showed stimulus-related deceleration, peaking on seconds 5-7 in all groups and an anticipatory acceleration peaking on seconds 3 and 4 in the right hemisphere groups, with decelerations during the corresponding seconds in the left hemisphere groups. The results are discussed in relation to recent findings by Walker and Sandman (1982) about the possibility of hemispheric specialization in psychologic influences on heart rate changes in response to environmental demands.

Adult↗
PubMed2000

Speed-accuracy trade-off in the performance of pointing movements in different directions in two-dimensional space.

Nine healthy subjects performed 2D pointing movements using a joystick that controlled a screen cursor. Continuous visual feedback was provided until movement completion. Three variables were systematically manipulated: (1) target distance, (2) target size and (3) target direction. A four-way factorial ANOVA was used to analyze the effects of these fixed factors and of the random factor of subject on several movement parameters. Movement time increased with increasing distance and decreasing target size and as predicted from Fitts' law. The target direction did not affect movement time. In contrast the direction, distance and size of the target significantly affected the movement time until the first zero crossing on the speed record reflecting the time to bring the arm into the vicinity of the target. Movements on the lateral axis of the horizontal plane (horizontal movements) resulted in a decrease in initial movement time compared to movements on the anterior axis of the horizontal plane (vertical movements). A significant effect of target distance and direction but not target size was observed for the magnitude of maximum acceleration, maximum speed and maximum deceleration. Horizontal movements had a larger maximum acceleration, speed and deceleration. Furthermore the maximum speed and deceleration occurred earlier in time for these horizontal movements. Finally the number of secondary peaks on the speed record increased with decreasing target size and was not affected by the target distance or target direction. In conclusion our results indicate that different movement parameters are affected by target distance, size and direction. The crucial distinction was between parameters affected by target size and direction. These parameters did not overlap. Target direction affects the first part of movement execution while target size affects the final part of movement execution. Thus a clear segmentation of movement execution in two phases is supported by these results. The implications of these results for theoretical models of speed-accuracy trade-off are discussed.

Acceleration↗
PubMed1998

Afferent feedback in the triphasic EMG pattern of leg muscles associated with rapid body sway.

Electromyographic (EMG) patterns of leg muscles associated with rapid body sway were studied in relation to displacement of the center of foot pressure (CFP). Standing subjects were instructed to shift the CFP by swaying their bodies, pivoting at the ankle as rapidly and accurately as possible after an auditory signal. CFP position was designated as N when the subject maintained a relaxed bending posture and as F when a maximally forward-leaning posture was maintained. A serial, stereotyped triphasic EMG pattern was observed in the rapid shift of CFP from N to F: cessation of EMG activity in the gastrocnemius (GC) muscle was followed by a burst in the tibialis anterior (TA) muscle (acceleration phase), and then resumed discharge occurred in the GC muscle with cessation of activity in the TA muscle (deceleration and stop). When the subject shifted the CFP from N to F to different degrees, the duration and amount of EMG activity in the TA muscle during acceleration and the GC muscle in deceleration were proportionate to the amount of CFP displacement associated with forward body sway. To determine the functional roles of sensory inputs from the foot on the triphasic EMG pattern, body sway was studied under the condition of sensory block in the feet induced by ischemia from tourniquets placed bilaterally just above the ankle joints. The triphasic EMG pattern persisted during ischemia. The time of GC cessation and the onset of TA burst at acceleration remained unchanged, but the times of TA cessation and resumption of GC discharge at deceleration were altered during ischemia. Moreover, subjects were unable to stop at F and eventually fell. These results indicate that both amount and duration of EMG activity associated with rapid body sway are functions of the amount of CFP displacement. Somatic sensation from the feet is important for control of burst and cessation timing and duration in leg muscle activity.

Adult↗
PubMed1998

Coordination of multi-joint arm movements in cerebellar ataxia: analysis of hand and angular kinematics.

Kinematic abnormalities of fast multijoint movements in cerebellar ataxia include abnormally increased curvature of hand trajectories and an increased hand path and are thought to originate from an impairment in generating appropriate levels of muscle torques to support normal coordination between shoulder and elbow joints. Such a mechanism predicts that kinematic abnormalities are pronounced when fast movements are performed and large muscular torques are required. Experimental evidence that systematically explores the effects of increasing movement velocities on movement kinematics in cerebellar multijoint movements is limited and to some extent contradictory. We, therefore, investigated angular and hand kinematics of natural multijoint pointing movements in patients with cerebellar degenerative disorders and healthy controls. Subjects performed self-paced vertical pointing movements with their right arms at three different target velocities. Limb movements were recorded in three-dimensional space using a two-camera infrared tracking system. Differences between patients and healthy subjects were most prominent when the subjects performed fast movements. Peak hand acceleration and deceleration were similar to normals during slow and moderate velocity movements but were smaller for fast movements. While altering movement velocities had little or no effect on the length of the hand path and angular motion of elbow and shoulder joints in normal subjects, the patients exhibited overshooting motions (hypermetria) of the hand and at both joints as movement velocity increased. Hypermetria at one joint always accompanied hypermetria at the neighboring joint. Peak elbow angular deceleration was markedly delayed in patients compared with normals. Other temporal movement variables such as the relative timing of shoulder and elbow joint motion onsets were normal in patients. Kinematic abnormalities of multijoint arm movements in cerebellar ataxia include hypermetria at both the elbow and the shoulder joint and, as a consequence, irregular and enlarged paths of the hand, and they are marked with fast but not with slow movements. Our findings suggest that kinematic movement abnormalities that characterize cerebellar limb ataxia are related to an impairment in scaling movement variables such as joint acceleration and deceleration normally with movement speed. Most likely, increased hand paths and decomposition of movement during slow movements, as described earlier, result from compensatory mechanisms the patients may employ if maximum movement accuracy is required.

Adult↗
PubMed2002

Plasma levels of natriuretic peptide and echocardiographic parameters in patients with Duchenne's progressive muscular dystrophy.

We investigated the relationship between plasma atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) levels and systolic and diastolic cardiac function, determined by echocardiography, in 63 patients with Duchenne's progressive muscular dystrophy (DMD) (age range 8-21 years). The relationship between shortening fraction of the left ventricle and ANP and BNP levels was curvilinear rather than linear: When the shortening fraction was >15%, increases in ANP and BNP levels were minimal. However, if the shortening fraction was <15%, both natriuretic peptide levels increased dramatically. Stepwise regression analysis revealed that only the deceleration time of the early diastolic filling wave predicted plasma BNP concentration among various diastolic echocardiographic parameters determined by mitral flow. Three patients died of cardiac dysfunction during a 2-year follow-up period. These patients had a severely decreased deceleration time (<65% of normal) in association with increases in both natriuretic peptide levels. In conclusion, plasma ANP and BNP levels are not sensitive markers for the early detection of cardiac systolic dysfunction in patients with DMD. However, in patients with systolic dysfunction, an increase in the concentrations of these peptides, associated with a decrease in the deceleration time of early diastolic filling, suggests poor prognosis.

Adolescent↗
PubMed1999

[Analysis of mitral annulus excursion with tissue Doppler echocardiography (tissue Doppler echocardiography = TDE). Noninvasive assessment of left ventricular, diastolic dysfunction].

BACKGROUND: Mitral inflow velocity, deceleration time, and isovolumic relaxation time recorded by Doppler echocardiography have been widely used to evaluate left ventricular diastolic function but are affected by age, heart rate, loading conditions, and other factors. The diastolic mitral anulus velocity assessed by tissue Doppler echocardiography (TDE) was suggested to provide additional information about LV relaxation less affected by filling pressures. AIM OF THE STUDY: This study was designed to assess the clinical utility of mitral anulus velocity in the evaluation of left ventricular diastolic function. PATIENTS AND METHODS: Three groups of patients with a systolic ejection fraction > 45% were separated: 10 normal volunteers (60 +/- 10 y, CON group), 15 asymptomatic patients with known coronary artery disease (60 +/- 11 y, CAD group) and 15 patients with long-term arterial hypertension and heart failure symptoms (58 +/- 9 y, HYP group). The mitral inflow profile (E, A, E/A) was measured by pulsed Doppler, and the deceleration time (DT) and the isovolumic relaxation period (IVRT) were calculated. Systolic, early, and late diastolic velocities of the septal mitral anulus (ST, ET, AT, ET/AT) were assessed by pulsed TDE. All study subjects had invasive measurements of left ventricular end diastolic filling pressures during left heart catheterization. RESULTS: In the AH group, ET (6.9 +/- 4.8 cm/s) and ET/AT (0.71 +/- 0.28) were reduced compared to the CON group (11.7 +/- 4.7 cm/s and 1.11 +/- 0.36, p < 0.05, respectively) and the CAD group (8.9 +/- 5.4 cm/s and 0.85 +/- 0.26, respectively, p = ns). The groups did not differ with respect to the mitral E/A ratio, the deceleration time and the isovolumic relaxation time. LVED in the HYP group (16 +/- 8 mm Hg) was elevated compared to the CON group (8 +/- 3, p < 0.05) and the CAD group (12 +/- 6 mm Hg, p = ns). No correlation was found between ET and LVED (r = 0.26). When the combination of mitral E/A ratio > 1 with LVED > or = 15 mm Hg was classified as pseudonormalization, the pseudonormalization could be identified by a peak early diastolic mitral anulus velocity (ET) < 7 cm/s and an ET/AT ratio < 1 with a sensitivity of 77% and a specificity of 88%. CONCLUSIONS: The early diastolic mitral anulus velocity assessed by TDE (ET) is a preload-independent index of LV relaxation. TDE permits the detection of diastolic dysfunction in patients with a pseudonormal mitral inflow and elevated filling pressures.

Adult↗