Correlation of Parameters of Superior Vena Caval Flow with Transtricuspid Flow Pattern

Abstract

Background:Pulmonary venous flow velocity pattern (PVFVP) is widely used to assess LV diastolic function. It is known that the parameters of PVFVP have a significant correlation with the ratio of peak early diastolic filling velocity (E) to peak filling velocity at atrial contraciton (A) measured in the transmitral flow. However, the correlations between parameters of superior vena caval flow (SVCF) and transtricuspid E/A ratio have not been reported. Therefore the present investigation was performed to elucidate these correlations. Methods:Fifty patients (26 men, mean age 63.1±11.1 years), who did not have significant tricuspid valvular disease and restrictive filling pattern on tricuspid and superior vena caval doppler, were included in this study. SVCF was recorded with the transducer positioned at subxiphoid area and the sample volume placed 2 cm within the superior vena cava. Blood flow across the tricuspid valve was obtained from standard four chamber view or modified parasternal four chamber view with the sample volume placed on leaflet tips. Recording was made during midexpiratory apnea. The following doppler parameters were measured: transtricuspid E and A velocity, E/A ratio;systolic (S) and diastolic (D) peak velocities and time velocity integrals (TVI), S/D velocity ratio, S/D TVI ratio, atrial reversal peak velocity (ArV) and TVI (ArTVI) in SVCF. Results:1) In SVCF, S velocity (63.7±11.8 cm/s vs 73.4±13.6 cm/sec, p 1. And D TVI (7.1±3.0 cm vs 5.2±3.1 cm, p 1. 2) As E/A ratio increased, diastolic TVI (r=0.315, p<0.05) and D/S TVI ratio (r=0.448, p<0.001) increased, and ArTVI (r=–0.376, p<0.01) and ArV (r=-0.416, p<0.01) decreased. 3) As E peak velocity increased, SVCF D peak velocity increased (r=0.305, p<0.05). Conclusions:Tricusupid E/A ratio has positive correlations with D TVI and D/S TVI ratio, and negative correlations with ArTVI and ArV. But there were no 논문접수일:1999년 8월 16일 심사완료일:1999년 12월 22일 교신저자:전두수, 403-720 인천광역시 부평구 부평 6동 665번지 가톨릭대학교 의과대학 내과학교실 전화:(032) 510-5500·전송:(032) 510-5683 E-mail:Cbmtci@ppp.kornet21.net