Combined Doppler index to track instantaneous changes in left ventricular filling pressure

The ratio of early transmitral pulsed Doppler velocity (E) to colour M-mode Doppler flow propagation velocity (Vp) has been reported to be a good predictor of pulmonary capillary wedge pressure (PCWP) and left ventricular end-diastolic pressure (LVEDP). It is unknown whether E/Vp can be used to reflect the instantaneous haemodynamic change after drug intervention.

The study population was composed of 19 patients who underwent elective cardiac catheterization for suspected coronary artery disease. Mean PCWP (mPCWP) obtained from right heart catheterization and LVEDP from a micromanometer-tipped catheter were compared with echocardiographic data before and 5 minutes after sublingual application of nitroglycerin (NTG) 0.6 mg. By stepwise multiple linear regression analysis, we found a positive correlation between mPCWP and E/Vp (beta, = 0.687, p = 0.001) and LVEDP and E/Vp (beta, = 0.718, p = 0.001). After NTG intake, the change in ENp was significantly correlated with the changes in mPCWP and LVEDP (r = 0.574, p = 0.010; r = 0.627, p = 0.004, respectively).

In addition to being a useful predictor of mPCWP and LVEDP, the index, E/Vp, can be used to track the instantaneous changes in mPCWP and LVEDRP.