Abstract
Background - Noninvasive assessment of diastolic filling by Doppler echocardiography provides important information about left ventricular (LV) status in selected subsets of patients. This study was designed to assess whether mitral annular velocities as assessed by tissue Doppler imaging are associated with invasive measures of diastolic LV performance and whether additional information is gained over traditional Doppler variables. Methods and Results - One hundred consecutive patients referred for cardiac catheterization underwent simultaneous Doppler interrogation. Invasive measurements of LV pressures were obtained with micromanometer-tipped catheters, and the mean LV diastolic pressure (M-LVDP) was used as a surrogate for mean left atrial pressure. Doppler signals from the mitral inflow, pulmonary venous inflow, and TDI of the mitral annulus were obtained. Isolated parameters of transmitral flow correlated with M-LVDP only when ejection fraction <50%. The ratio of mitral velocity to early diastolic velocity of the mitral annulus (E/E') showed a better correlation with M-LVDP than did other Doppler variables for all levels of systolic function. E/E' <8 accurately predicted nodal M-LVDP, and E/E' > 15 identified increased M-LVDP. Wide variability was present in those with E/E' of 8 to 15. A subset of those patients with E/E' 8 to 15 could be further defined by use of other Doppler data. Conclusions The combination of tissue Doppler imaging of the mitral annulus and mitral inflow velocity curves provides better estimates of LV filling pressures than other methods (pulmonary vein, preload reduction). However, accurate prediction of filling pressures for an individual patient requires a stepwise approach incorporating all available data.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1788-1794 |
| Number of pages | 7 |
| Journal | Circulation |
| Volume | 102 |
| Issue number | 15 |
| State | Published - Oct 10 2000 |
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Keywords
- Diastole
- Echocardiography
- Pressure
ASJC Scopus subject areas
- Physiology
- Cardiology and Cardiovascular Medicine
Cite this
Clinical utility of Doppler echocardiography and tissue Doppler imaging in the estimation of left ventricular filling pressures : A comparative simultaneous Doppler-catheterization study. / Ommen, Steve R.; Nishimura, R. A.; Appleton, C. P.; Miller, Fletcher A Jr.; Oh, Jae Kuen; Redfield, Margaret May; Tajik, A. J.
In: Circulation, Vol. 102, No. 15, 10.10.2000, p. 1788-1794.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Clinical utility of Doppler echocardiography and tissue Doppler imaging in the estimation of left ventricular filling pressures
T2 - A comparative simultaneous Doppler-catheterization study
AU - Ommen, Steve R.
AU - Nishimura, R. A.
AU - Appleton, C. P.
AU - Miller, Fletcher A Jr.
AU - Oh, Jae Kuen
AU - Redfield, Margaret May
AU - Tajik, A. J.
PY - 2000/10/10
Y1 - 2000/10/10
N2 - Background - Noninvasive assessment of diastolic filling by Doppler echocardiography provides important information about left ventricular (LV) status in selected subsets of patients. This study was designed to assess whether mitral annular velocities as assessed by tissue Doppler imaging are associated with invasive measures of diastolic LV performance and whether additional information is gained over traditional Doppler variables. Methods and Results - One hundred consecutive patients referred for cardiac catheterization underwent simultaneous Doppler interrogation. Invasive measurements of LV pressures were obtained with micromanometer-tipped catheters, and the mean LV diastolic pressure (M-LVDP) was used as a surrogate for mean left atrial pressure. Doppler signals from the mitral inflow, pulmonary venous inflow, and TDI of the mitral annulus were obtained. Isolated parameters of transmitral flow correlated with M-LVDP only when ejection fraction <50%. The ratio of mitral velocity to early diastolic velocity of the mitral annulus (E/E') showed a better correlation with M-LVDP than did other Doppler variables for all levels of systolic function. E/E' <8 accurately predicted nodal M-LVDP, and E/E' > 15 identified increased M-LVDP. Wide variability was present in those with E/E' of 8 to 15. A subset of those patients with E/E' 8 to 15 could be further defined by use of other Doppler data. Conclusions The combination of tissue Doppler imaging of the mitral annulus and mitral inflow velocity curves provides better estimates of LV filling pressures than other methods (pulmonary vein, preload reduction). However, accurate prediction of filling pressures for an individual patient requires a stepwise approach incorporating all available data.
AB - Background - Noninvasive assessment of diastolic filling by Doppler echocardiography provides important information about left ventricular (LV) status in selected subsets of patients. This study was designed to assess whether mitral annular velocities as assessed by tissue Doppler imaging are associated with invasive measures of diastolic LV performance and whether additional information is gained over traditional Doppler variables. Methods and Results - One hundred consecutive patients referred for cardiac catheterization underwent simultaneous Doppler interrogation. Invasive measurements of LV pressures were obtained with micromanometer-tipped catheters, and the mean LV diastolic pressure (M-LVDP) was used as a surrogate for mean left atrial pressure. Doppler signals from the mitral inflow, pulmonary venous inflow, and TDI of the mitral annulus were obtained. Isolated parameters of transmitral flow correlated with M-LVDP only when ejection fraction <50%. The ratio of mitral velocity to early diastolic velocity of the mitral annulus (E/E') showed a better correlation with M-LVDP than did other Doppler variables for all levels of systolic function. E/E' <8 accurately predicted nodal M-LVDP, and E/E' > 15 identified increased M-LVDP. Wide variability was present in those with E/E' of 8 to 15. A subset of those patients with E/E' 8 to 15 could be further defined by use of other Doppler data. Conclusions The combination of tissue Doppler imaging of the mitral annulus and mitral inflow velocity curves provides better estimates of LV filling pressures than other methods (pulmonary vein, preload reduction). However, accurate prediction of filling pressures for an individual patient requires a stepwise approach incorporating all available data.
KW - Diastole
KW - Echocardiography
KW - Pressure
UR - http://www.scopus.com/inward/record.url?scp=0034633812&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0034633812&partnerID=8YFLogxK
M3 - Article
C2 - 11023933
AN - SCOPUS:0034633812
VL - 102
SP - 1788
EP - 1794
JO - Circulation
JF - Circulation
SN - 0009-7322
IS - 15
ER -