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Acute effects of positive end-expiratory pressure on left ventricle diastolic function in healthy subjects

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Abstract

We evaluated the acute effect of the application of positive end-expiratory pressure (PEEP) on LV diastolic function in 10 healthy subjects. We assessed load dependent diastolic function by Doppler examination of transmitral flow and load independent diastolic function by color M-mode propagation velocity of early flow into the LV cavity (Vp). During the application of PEEP in comparison to the baseline, we found a significant reduction of the E wave peak velocity [79 (64–83) vs. 65 (57–72) cm/s; p = 0.028] and a significant reduction in Vp [84 (73–97) vs. 53 (48–66); p = 0.012]. Moreover, we found a significant reduction in left atrial area [15 (13–18) vs. 12 (10–14) cm2; p = 0.018] and right atrial area [12 (11–15) vs. 11 (9–12) cm2; p = 0.015]. No difference was found in global LV systolic function. The application of PEEP acutely modifies the diastolic flow pattern across the mitral valve, and reduces atrial dimensions.

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Conflict of interest statement

The authors declare that they have no conflict of interest related to the publication of this manuscript.

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Authors and Affiliations

  1. U.O. Cardiologia, P.C. Carate B-Giussano, Azienda Ospedaliera di Desio e Vimercate, Via Milano 65, Giussano, 20038, Milan, Italy

    Alberto Maestroni

  2. Dipartimento Toraco-Polmonare e Cardio-Vascolare, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, University of Milan, Via F. Sforza 35, 20122, Milan, Italy

    Stefano Aliberti & Giuseppe Milani

  3. Harvard School of Public Health, 708 Huntington Avenue, Boston, MA, 02115, USA

    Omar Amir

  4. Emergency Medicine Department, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Via F. Sforza 35, 20122, Milan, Italy

    Anna Maria Brambilla, Federico Piffer, Francesca Tardini & Roberto Cosentini

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  1. Alberto Maestroni
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  2. Stefano Aliberti
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  3. Omar Amir
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  4. Giuseppe Milani
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  5. Anna Maria Brambilla
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  6. Federico Piffer
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  7. Francesca Tardini
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  8. Roberto Cosentini
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Correspondence to Alberto Maestroni.

Additional information

The work was presented in part as an oral communication at the 2004 SMART.

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Maestroni, A., Aliberti, S., Amir, O. et al. Acute effects of positive end-expiratory pressure on left ventricle diastolic function in healthy subjects. Intern Emerg Med 4, 249–254 (2009). https://doi.org/10.1007/s11739-009-0255-2

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  • DOI: https://doi.org/10.1007/s11739-009-0255-2

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