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Document Details : Title: Combined Doppler index to track instantaneous changes in left ventricular filing pressure Author(s): SU, Ho-Ming , LIN, Tsung-Hsien , VOON, Wen-Chol , LAI, Wen-Ter , SHEU, Sheng-Hsiung Journal: Acta Cardiologica Volume: 60 Issue: 4 Date: August 2005 Pages: 421-425 DOI: 10.2143/AC.60.4.2004992 Abstract : Objective — The ratio of early transmitral pulsed Doppler velocity (E) to colour M-mode Doppler flow propagation velocity (Vp) has been reported to be a good predictor of pulmonary capillary wedge pressure (PCWP) and left ventricular end-diastolic pressure (LVEDP). It is unknown whether E/Vp can be used to reflect the instantaneous haemodynamic change after drug intervention. Methods and results — The study population was composed of 19 patients who underwent elective cardiac catheterization for suspected coronary artery disease. Mean PCWP (mPCWP) obtained from right heart catheterization and LVEDP from a micromanometer-tipped catheter were compared with echocardiographic data before and 5 minutes after sublingual application of nitroglycerin (NTG) 0.6 mg. By stepwise multiple linear regression analysis, we found a positive correlation between mPCWP and E/Vp (b‚ = 0.687, p = 0.001) and LVEDP and E/Vp (b‚ = 0.718, p = 0.001). After NTG intake, the change in E/Vp was significantly correlated with the changes in mPCWP and LVEDP (r = 0.574, p = 0.010; r = 0.627, p = 0.004, respectively). Conclusions — In addition to being a useful predictor of mPCWP and LVEDP, the index, E/Vp, can be used to track the instantaneous changes in mPCWP and LVEDP. |
