Determination of left ventricular filling pressure by Doppler echocardiography in patients with coronary artery disease

Critical role of left ventricular systolic function

Kazuhiro Yamamoto, Rick A. Nishimura, Hari P Chaliki, Christopher P. Appleton, David Holmes, Margaret May Redfield

Research output: Contribution to journalArticle

221 Citations (Scopus)

Abstract

Objectives. This study was designed to determine the usefulness of transthoracic Doppler measurements in detecting increased left ventricular (LV) end-diastolic pressure in patients with coronary artery disease, specifically examining the influence of systolic function on the accuracy of these methods. Background. Studies that have correlated Doppler indexes with LV filling pressures primarily involved patients with LV systolic dysfunction. The reliability of Doppler indexes in estimating filling pressures in patients with coronary artery disease and preserved systolic function is unclear. Methods. Pulsed wave Doppler transmittal and pulmonary venous flow velocity curves and LV pressure were recorded in 83 patients with coronary artery disease. Results. Conventional Doppler indexes (deceleration time of mitral E wave velocity, ratio of peak mitral E to A wave velocities and pulmonary venous systolic fraction) correlated with LV filling pressure in patients with an ejection fraction (EF) ≤50% but not in those with an EF >50%. Previously published regression analysis for prediction of LV filling pressure was accurate in patients with an EF ≤50% but not in those with an EF >50%. The difference between flow duration with atrial contraction in the pulmonary veins and transmitral flow duration with atrial contraction correlated with LV filling pressure in both groups. Conclusions. Analysis of the early diastolic portion of the transmitral or pulmonary venous flow velocity curves can be used to predict LV filling pressures in patients with systolic dysfunction, but are inaccurate in patients with preserved systolic function. The combined analysis of both flow velocity curves at atrial contraction is a reliable, feasible predictor of increased LV filling pressure, irrespective of systolic function.

Original languageEnglish (US)
Pages (from-to)1819-1826
Number of pages8
JournalJournal of the American College of Cardiology
Volume30
Issue number7
DOIs
StatePublished - Dec 1997

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Doppler Echocardiography
Ventricular Pressure
Left Ventricular Function
Coronary Artery Disease
Lung
Deceleration
Pulmonary Veins
Left Ventricular Dysfunction
Regression Analysis
Blood Pressure
Pressure

ASJC Scopus subject areas

  • Nursing(all)

Cite this

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title = "Determination of left ventricular filling pressure by Doppler echocardiography in patients with coronary artery disease: Critical role of left ventricular systolic function",
abstract = "Objectives. This study was designed to determine the usefulness of transthoracic Doppler measurements in detecting increased left ventricular (LV) end-diastolic pressure in patients with coronary artery disease, specifically examining the influence of systolic function on the accuracy of these methods. Background. Studies that have correlated Doppler indexes with LV filling pressures primarily involved patients with LV systolic dysfunction. The reliability of Doppler indexes in estimating filling pressures in patients with coronary artery disease and preserved systolic function is unclear. Methods. Pulsed wave Doppler transmittal and pulmonary venous flow velocity curves and LV pressure were recorded in 83 patients with coronary artery disease. Results. Conventional Doppler indexes (deceleration time of mitral E wave velocity, ratio of peak mitral E to A wave velocities and pulmonary venous systolic fraction) correlated with LV filling pressure in patients with an ejection fraction (EF) ≤50{\%} but not in those with an EF >50{\%}. Previously published regression analysis for prediction of LV filling pressure was accurate in patients with an EF ≤50{\%} but not in those with an EF >50{\%}. The difference between flow duration with atrial contraction in the pulmonary veins and transmitral flow duration with atrial contraction correlated with LV filling pressure in both groups. Conclusions. Analysis of the early diastolic portion of the transmitral or pulmonary venous flow velocity curves can be used to predict LV filling pressures in patients with systolic dysfunction, but are inaccurate in patients with preserved systolic function. The combined analysis of both flow velocity curves at atrial contraction is a reliable, feasible predictor of increased LV filling pressure, irrespective of systolic function.",
author = "Kazuhiro Yamamoto and Nishimura, {Rick A.} and Chaliki, {Hari P} and Appleton, {Christopher P.} and David Holmes and Redfield, {Margaret May}",
year = "1997",
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TY - JOUR

T1 - Determination of left ventricular filling pressure by Doppler echocardiography in patients with coronary artery disease

T2 - Critical role of left ventricular systolic function

AU - Yamamoto, Kazuhiro

AU - Nishimura, Rick A.

AU - Chaliki, Hari P

AU - Appleton, Christopher P.

AU - Holmes, David

AU - Redfield, Margaret May

PY - 1997/12

Y1 - 1997/12

N2 - Objectives. This study was designed to determine the usefulness of transthoracic Doppler measurements in detecting increased left ventricular (LV) end-diastolic pressure in patients with coronary artery disease, specifically examining the influence of systolic function on the accuracy of these methods. Background. Studies that have correlated Doppler indexes with LV filling pressures primarily involved patients with LV systolic dysfunction. The reliability of Doppler indexes in estimating filling pressures in patients with coronary artery disease and preserved systolic function is unclear. Methods. Pulsed wave Doppler transmittal and pulmonary venous flow velocity curves and LV pressure were recorded in 83 patients with coronary artery disease. Results. Conventional Doppler indexes (deceleration time of mitral E wave velocity, ratio of peak mitral E to A wave velocities and pulmonary venous systolic fraction) correlated with LV filling pressure in patients with an ejection fraction (EF) ≤50% but not in those with an EF >50%. Previously published regression analysis for prediction of LV filling pressure was accurate in patients with an EF ≤50% but not in those with an EF >50%. The difference between flow duration with atrial contraction in the pulmonary veins and transmitral flow duration with atrial contraction correlated with LV filling pressure in both groups. Conclusions. Analysis of the early diastolic portion of the transmitral or pulmonary venous flow velocity curves can be used to predict LV filling pressures in patients with systolic dysfunction, but are inaccurate in patients with preserved systolic function. The combined analysis of both flow velocity curves at atrial contraction is a reliable, feasible predictor of increased LV filling pressure, irrespective of systolic function.

AB - Objectives. This study was designed to determine the usefulness of transthoracic Doppler measurements in detecting increased left ventricular (LV) end-diastolic pressure in patients with coronary artery disease, specifically examining the influence of systolic function on the accuracy of these methods. Background. Studies that have correlated Doppler indexes with LV filling pressures primarily involved patients with LV systolic dysfunction. The reliability of Doppler indexes in estimating filling pressures in patients with coronary artery disease and preserved systolic function is unclear. Methods. Pulsed wave Doppler transmittal and pulmonary venous flow velocity curves and LV pressure were recorded in 83 patients with coronary artery disease. Results. Conventional Doppler indexes (deceleration time of mitral E wave velocity, ratio of peak mitral E to A wave velocities and pulmonary venous systolic fraction) correlated with LV filling pressure in patients with an ejection fraction (EF) ≤50% but not in those with an EF >50%. Previously published regression analysis for prediction of LV filling pressure was accurate in patients with an EF ≤50% but not in those with an EF >50%. The difference between flow duration with atrial contraction in the pulmonary veins and transmitral flow duration with atrial contraction correlated with LV filling pressure in both groups. Conclusions. Analysis of the early diastolic portion of the transmitral or pulmonary venous flow velocity curves can be used to predict LV filling pressures in patients with systolic dysfunction, but are inaccurate in patients with preserved systolic function. The combined analysis of both flow velocity curves at atrial contraction is a reliable, feasible predictor of increased LV filling pressure, irrespective of systolic function.

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