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[Practical assessment using transmitral Doppler echocardiography for the evaluation of left ventricular filling
W Weihs1, B Anelli-Monti, H Schuchlenz
1Kardiopulmonalen Department, Landeskrankenhauses, Graz. wolfgang.weihs@lkh-graz.or.at
Insights
Doppler echocardiography can assess left ventricular filling pressures in patients with systolic dysfunction. Early diastolic deceleration time (DT) effectively predicts filling pressures, aiding in diagnosing heart failure.
Area of Science:
- Cardiology
- Echocardiography
- Physiology
Background:
- Transmitral flow velocity profiles are linked to left ventricular diastolic properties.
- Assessing left ventricular filling pressures is crucial in patients with impaired systolic function.
Purpose of the Study:
- To evaluate the use of transmitral flow velocity curves for assessing left ventricular filling pressures in patients with systolic dysfunction.
Main Methods:
- Doppler echocardiography was performed on 90 patients with ejection fraction ≤45%.
- Measured early diastolic deceleration time (DT) and peak velocity ratio (VE/VA).
- Correlated these measurements with left ventricular end-diastolic pressures from left heart catheterization.
Main Results:
- DT and VE/VA significantly correlated with left ventricular end-diastolic pressures.
- Restrictive filling patterns (DT < 160) indicated elevated pressures; impaired relaxation (DT > 210) predicted normal pressures.
- DT also correlated with clinical signs of left heart failure.
Conclusions:
- Doppler echocardiography provides valuable information on left ventricular filling pressures in systolic dysfunction.
- DT is a reliable predictor of filling pressures and aids in heart failure assessment.
Abstract:
Transmitral flow velocity profiles by Doppler echocardiography are strongly related to left ventricular diastolic properties. The aim of this study was to address the assessment of left ventricular filling pressures by transmitral flow velocity curves in patients with impaired systolic function. 90 patients (23 female, 67 men, age 60.0 +/- 9,9 a) with an ejection fraction < or = 45% either due to coronary artery disease (n = 67) or dilated cardiomyopathy (n = 23) were investigated by Doppler echocardiography prior to left heart catheterization. Early diastolic deceleration time (DT) and ratio of early to late diastolic peak velocities (VE/VA) were measured. Both, DT and VE/VA showed a significant correlation to left ventricular enddiastolic pressures (r = -0.79 respectively r = 0.73, p < 0.001 for all). According to DT three different transmitral flow patterns were identified. All patients with restrictive filling patterns (DT < 160) had elevated left ventricular filling pressures, whereas impaired relaxation (DT > 210) was a strong predictor of normal filling pressures. In patients with pseudonormal transmitral flow patterns (DT 160 to 210) filling pressures could not be predicted. Furthermore DT was strongly related to clinical signs of left heart failure. Doppler echocardiography gives useful additional information on left ventricular filling pressures in patients with systolic dysfunction.