The importance of pulmonary venous flow measurement for evaluating left ventricular end-diastolic pressure in patients with coronary artery disease in the early stage of diastolic dysfunction

Citation
K. Kimura et al., The importance of pulmonary venous flow measurement for evaluating left ventricular end-diastolic pressure in patients with coronary artery disease in the early stage of diastolic dysfunction, J AM S ECHO, 14(10), 2001, pp. 987-993
Citations number
18
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Cardiovascular & Respiratory Systems
Journal title
JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY
ISSN journal
0894-7317 → ACNP
Volume
14
Issue
10
Year of publication
2001
Pages
987 - 993
Database
ISI
SICI code
0894-7317(200110)14:10<987:TIOPVF>2.0.ZU;2-Y
Abstract
Transmitral flow pattern assessed by pulsed Doppler echocardiography is wid ely used to evaluate left ventricular end-diastolic pressure (LVEDP). A res trictive mitral flow pattern is well recognized as a finding of severely el evated LVEDP. On the other hand, an abnormal relaxation pattern can be inte rpreted many ways. For example, some patients who display an abnormal relax ation pattern have a mild impairment of left ventricular (LV) relaxation as a result of aging, and others have severely impaired LV diastolic function . To evaluate LVEDP in patients with abnormal relaxation mitral filling pat terns, we studied 55 patients who had coronary artery disease with abnormal relaxation pattern who underwent elective cardiac catheterization. We reco rded the transmitral and pulmonary venous flow velocity curves and measured . the duration of the mitral A wave (MAd) and pulmonary venous reversal wav e during atrial contraction (PAd). Positive correlations were found between PAd and LVEDP (r = 0.65, P < .01) and between PAd-MAd and LVEDP (r = 0.7, P < .0001); however, MAd was not significantly correlated with LVEDP. In co nclusion, PAd must be measured for an accurate evaluation of LV end-diastol ic pressure in patients with an abnormal relaxation pattern in the transmit ral flow velocity curve.