Evaluation of Left Ventricular Diastolic Function in Coronary Artery Disease by Transthoracic Doppler Ultrasound Measurement of Mitral and Pulmonary Venous Flow Velocities

Abstract

Background:A widened left atrial pressure A wave occurs when left ventricular end-diastolic pressure is increased. It has been reported that increased duration of pulmonary venous flow reversal at atrial systole might be a marker for elevated left ventricular end-diastolic pressure. Decreased systolic pulmonary venous flow is shown to be related to increased left ventricular filling pressure in studies using transesophageal Doppler echocardiography. We evaluate the correlation between LVEDP measured by the invasive method and the mitral and pulmonary venous flow index recorded by transthoracic Doppler echocardiography. Methods:Left ventricular pressures at late diastole were measured by fluid-filled catheters in 70-consecutive coronary heart patients undergoing diagnostic cardiac catheterization. Pulmonary venous and mitral flow velocities were recorded by transthoracic pulsed Doppler ultrasound. Adequate recordings were obtained in the 70 patients. Diastolic function differentiated into four categories . Results:Pulmonary venous flow reversal exceeding the duration of the mitral A wave predicted left ventricular end-diastolic pressure ≥ 18mmHg with a sensitivity of 0.78 and a specificity of 0.95. * 본 논문의 요지는 1996년 추계 순환기 학회에 발표되었음.