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Martin Ugander Profile picture
@mugander
Nov 1, 2022 • 5 tweets • 3 min read Twitter logo Read on Twitter
#EchoFirst & diastolic dysfunction - what do you know about:
✅hydraulic forces
✅myocardial stiffness
✅damping

Learn more in this talk I recently gave at Echo Australia 2022.

🫀🔊
#BoingBoing

Did you know that #HydraulicForces:
✅are related to the relative size of the LA in relation to the LV?
✅contribute to left ventricular diastolic function?
✅associate independently with survival?
Myocardial #stiffness and #damping are mechanistic ⚙️properties of the LV that can be estimated by measuring the Doppler 🔊 E wave peak velocity, acceleration time ⏲️, and deceleration time ⏲️.

More in this separate thread:

Not all diastolic dysfunction manifests in the same way. HFpEF has increased damping, whereas HFrEF has increased stiffness.

#SameSameButDifferent
All this an more are touched upon in this talk:

• • •

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More from @mugander

Martin Ugander Profile picture
Feb 10, 2022
Do you routinely measure #MAPSE?

Did you know that MAPSE beats #GLS and #LVEF regarding prognosis?

A new multicenter collab study out, led by @KellmanPeter

Ref: pubmed.gov/35132872

#WhyCMR 🫀🧲 #EchoFirst 🫀🔊

A thread 🧵. 1/n
We know that GLS is a composite measure correlated w LVEF, LVEDV, LVESV, LV mass, infarction, non-ischemic scar, aortic stenosis, mitral regurg, ECV.

So, not surprisingly, GLS associates with poor prognosis.

Ref: pubmed.gov/32563637 Suppl Table 2

2/n
Notably, mitral annular plane systolic excursion #MAPSE has been measurable by #EchoFirst since 1986 by M-mode (pubmed.gov/3464160).

3/n From pubmed.gov/3464160, Figure 3-4B, M-mode recording of th
Read 11 tweets
Martin Ugander Profile picture
Oct 28, 2020
When it comes to LV diastolic (dys)function, let's think of the LV like a spring, which is compressed during systole, and recoils during diastole.

A thread 🧵
1/n
@strain_rate @load_dependent @DrWillWatson @shaunrobinson02 @leoshmu
The physics governing the recoil of a spring are well described as a damped harmonic oscillator, and it is well validated that the Doppler E-wave is governed by these same physics, aka parameterized diastolic filling (PDF) [pubmed.gov/3812709].
2/n
This means that the shape of the E-wave can be excellently curve fit to a function that describes the behavior of a damped harmonic oscillator. Figure from pubmed.gov/33066772
3/n
Read 15 tweets

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