Pulmonary venous flow velocity pattern as assessed with transthoracic pulsed Doppler echocardiography in subjects without cardiac disease

Abstract

Pulmonary venous flow velocity pattern (PVFVP) was analyzed in 53 subjects (aged 25 to 77 years, mean 47) without cardiovascular disease who underwent transthoracic pulsed Doppler echocardiography. The forward flow velocity pattern was biphasic in 37 of the 53 subjects, with each of the 2 peaks in systole and diastole; flow was triphasic with 2 peaks in systole and the other peak in diastole in the remaining 16 subjects. Peak systolic and diastolic flow velocity ranged from 28 to 84 cm/s and from 27 to 71 cm/s, respectively. Mean systolic flow velocity was significantly greater than mean diastolic flow velocity (53 ± 12 vs 47 ± 11 cm/s, p < 0.01). Systolic flow velocity and the ratio of systolic to diastolic flow velocity increased and diastolic flow velocity decreased with aging (r = 0.52, p < 0.001, r = 0.70, p < 0.001 and r = −0.49, p < 0.001, respectively). Reverse flow occurred during the atrial contraction phase and its velocity (mean 20 cm/s) increased with aging (r = 0.56, p < 0.001). The parameters of PVFVP were compared with the ratio of peak early diastolic filling velocity to peak filling velocity at atrial contraction ( E A ratio) measured in the transmitral flow velocity pattern. As E A ratio increased, systolic flow velocity and systolic/ diastolic flow ratio and peak reverse flow velocity decreased (r = −0.40, p < 0.01, r = −0.67, p < 0.001 and r = −0.68, p < 0.001, respectively) and diastolic flow velocity increased (r = 0.58, p < 0.001). Thus, PVFVP can be assessed in adults by using transthoracic pulsed Doppler echocardiography. PVFVP is significantly affected by aging, at least partially reflecting altered left ventricular diastolic function with aging. These results can be used for comparison with patterns found in disease states.