Inward diastolic motion: a normal component of isovolumic relaxation and rapid refill

Abstract

Many reports note expansive events occurring in the left ventricle during isovolumic relaxation. Expansions during isovolumic relaxation require compensatory inward displacements elsewhere in the ventricle. The location and character of such compensatory displacements have been a continuing source of speculation. Using a high-precision Compton backscatter imaging (CBI) technique, we have detected an early diastolic inward motion that initiates during isovolumic relaxation on the right and left epicardial free walls of the heart in 100% of the 14 normal canines we have studied. This inward motion is first detected 20–30 ms after left ventricular maximal rate of pressure decrease over time (-dP/dtmax), lasts into the early rapid filling phase with a mean duration of 92 +/- 5 (SE) ms, and ends approximately 30 ms after opening of the mitral valve. Maximum wall velocities during this time period (approximately 20 mm/s) exceed those occurring in the same regions during systole. Inward surface displacements in the areas undergoing inward motion average 1.1 +/- 0.2 and 0.9 +/- 0.2 mm on the left and right side of the heart, respectively.