The rate of change of left ventricular volume in man. II. Diastolic events in health and disease.

Because there is little quantitative information about the hemodynamics of left ventricular diastolic events in man, single-plane cineangiographic left ventricular volume curves were quantitatively analyzed at 16.6 msec intervals to evaluate the rate and amount of left ventricular filling during the early passive stage of filling and during the time of atrial contraction. The peak rate of passive diastolic filling of the left ventricle (D dV/dt), the peak rate of filling during atrial contraction (dV/dt E 'a'), and the increment in diastolic left ventricular volume due to atrial contraction (AV c 'a') were analyzed for a group of 110 adult patients with a variety of cardiac lesions. Normal D dV/dt, 503 171 cc/sec, was significantly depressed in patients with mitral stenosis (393 + 109 cc/sec) and coronary artery disease (394 150 cc/sec). When corrected for end-diastolic volume (EDV), the resultant D dV/dt/EDV was significantly depressed in all disease states studied. D dV/dt corrected similarly for total left ventricular stroke volume (SV)