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[Differentiation between "pseudonormal" from normal transmitral flow velocity waveforms by evaluating isovolumic
T Hashimoto1, N Ohte, H Narita
1Third Department of Internal Medicine, Nagoya City University Medical School.
Journal of Cardiology
|January 1, 1992
Summary
Isovolumic relaxation time (IRT) helps differentiate normal from pseudonormal transmitral flow in patients with myocardial infarction. Lower early peak filling velocity (E) and E/A ratio indicate diastolic dysfunction in patients with lower pulmonary capillary wedge pressure.
Area of Science:
- Cardiology
- Echocardiography
- Physiology
Background:
- Distinguishing pseudonormal transmitral flow from normal flow is crucial for assessing diastolic function.
- Myocardial infarction can lead to diastolic dysfunction, altering transmitral flow patterns.
Purpose of the Study:
- To evaluate isovolumic relaxation time (IRT) for differentiating pseudonormal from normal transmitral flow velocity waveforms.
- To assess diastolic function in patients with old myocardial infarction using Doppler echocardiography.
Main Methods:
- Transmitral flow velocity waveforms were obtained using pulsed Doppler echocardiography and phonocardiography.
- Key parameters measured included early peak filling velocity (E), late peak filling velocity (A), E/A ratio, and IRT.
- Patients with old myocardial infarction were categorized based on mean pulmonary capillary wedge pressure (mPCWP).
Main Results:
- A positive correlation was found between IRT and age in healthy volunteers.
- Patients with lower mPCWP (< 16 mmHg) showed significantly lower E and E/A ratios compared to controls.
- No significant differences in E and E/A were observed between patients with higher mPCWP (>= 16 mmHg) and controls.
Conclusions:
- IRT, along with transmitral flow parameters, can aid in differentiating pseudonormal from normal flow patterns.
- Reduced E and E/A ratios in patients with old myocardial infarction and lower mPCWP suggest impaired diastolic function.