Demonstration of restrictive ventricular physiology by Doppler echocardiography

Christopher P. Appleton, Liv K. Hatle, Richard L. Popp

Research output: Contribution to journalArticle

304 Citations (Scopus)

Abstract

In patients with restriction of cardiac filling of various origins, cardiac catheterization has been traditionally used as part of the diagnostic evaluation to verify the presence of restrictive/constrictive hemodynamics. In an attempt to determine whether this "restrictive" physiology could be demonstrated noninvasively, 14 patients who had a history, physical examination, two-dimensional echocardiogram and catheterization data compatible with a restrictive myocardial process were studied with pulsed wave Doppler ultrasound. Forty normal subjects served as a control group. The Doppler ultrasound evaluation included measurement of peak mitral and tricuspid flow velocities and flow velocity integrals, mitral and tricuspid deceleration times and central venous flow patterns during apnea and inspiration. The flow velocity recordings across the mitral and tricuspid valves in patients manifesting restriction were markedly different from those in normal subjects, showing shortened deceleration times across both valves, which indicated both an abrupt premature cessation of ventricular filling and the presence of a diastolic dip-plateau contour in ventricular pressure recordings. In addition, abnormal central venous flow velocity reversals with inspiration and diastolic mitral and tricuspid regurgitation were frequently observed, also suggesting the reduced myocardial compliance characteristic of a restrictive myocardial process.

Original languageEnglish (US)
Pages (from-to)757-768
Number of pages12
JournalJournal of the American College of Cardiology
Volume11
Issue number4
DOIs
StatePublished - 1988
Externally publishedYes

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Doppler Echocardiography
Doppler Ultrasonography
Deceleration
Tricuspid Valve Insufficiency
Tricuspid Valve
Mitral Valve Insufficiency
Ventricular Pressure
Apnea
Cardiac Catheterization
Mitral Valve
Catheterization
Compliance
Physical Examination
Hemodynamics
History
Control Groups

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Demonstration of restrictive ventricular physiology by Doppler echocardiography. / Appleton, Christopher P.; Hatle, Liv K.; Popp, Richard L.

In: Journal of the American College of Cardiology, Vol. 11, No. 4, 1988, p. 757-768.

Research output: Contribution to journalArticle

Appleton, Christopher P. ; Hatle, Liv K. ; Popp, Richard L. / Demonstration of restrictive ventricular physiology by Doppler echocardiography. In: Journal of the American College of Cardiology. 1988 ; Vol. 11, No. 4. pp. 757-768.
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