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Assessment of superior vena caval blood flow velocity in ischemic heart disease
1First Department of Internal Medicine, Osaka City University Medical School, Japan.
Insights
Inferior or inferoposterior myocardial infarction (INF + POS) significantly impairs right atrial reservoir function. This is indicated by reduced systolic peak flow velocity in the superior vena cava, assessed via Doppler echocardiography.
Area of Science:
- Cardiology
- Echocardiography
- Cardiovascular Physiology
Background:
- Ischemic heart disease (IHD) encompasses conditions like myocardial infarction and angina.
- Right atrial function plays a crucial role in overall cardiac hemodynamics.
- Assessing right atrial function can provide insights into the impact of IHD on cardiovascular health.
Purpose of the Study:
- To evaluate right atrial function in patients with different types of ischemic heart disease.
- To investigate the relationship between specific infarct locations and alterations in right atrial function.
- To determine if Doppler echocardiography of superior vena caval blood flow can detect these functional changes.
Main Methods:
- Pulsed Doppler echocardiography was used to measure superior vena caval blood flow velocity.
- Study included 31 patients with anteroseptal infarction (ANT), 23 with inferior/inferoposterior infarction (INF + POS), 27 with effort angina (EAP), and 15 with vasospastic angina (VAP).
- Systolic peak flow velocity (PFVs) and diastolic peak flow velocity (PFVd) were analyzed, along with the PFVs/PFVd ratio.
Main Results:
- Systolic peak flow velocity (PFVs) was significantly reduced in the INF + POS group compared to ANT, EAP, and VAP groups (p < 0.05).
- No significant difference in diastolic peak flow velocity (PFVd) was observed among the four groups.
- The PFVs/PFVd ratio was significantly lower in the INF + POS group compared to the other groups (p < 0.05).
Conclusions:
- Inferior or inferoposterior infarction (INF + POS) is associated with impaired right atrial reservoir function.
- Reduced PFVs and PFVs/PFVd ratio in Doppler assessment of superior vena cava flow indicate this impairment.
- Doppler echocardiography is a valuable tool for evaluating right atrial function in patients with ischemic heart disease.
Abstract:
In order to evaluate the right atrial function in patients with ischemic heart-disease, we studied the superior vena caval blood flow velocity using pulsed Doppler echocardiography. The subjects included 31 patients with anteroseptal infarction (ANT), 23 with inferior or inferoposterior infarction (INF + POS), 27 with effort angina pectoris (EAP) and 15 with vasospastic angina pectoris (VAP). The systolic peak flow velocity (PFVs) was significantly reduced only in INF + POS compared with those in ANT, EAP and VAP (36.8 +/- 1.8 cm/sec vs 46.9 +/- 2.1 cm/sec, 46.4 +/- 2.1 cm/sec and 42.6 +/- 1.9 cm/sec, p less than 0.05, respectively). No significant difference in diastolic peak flow velocity (PFVd) was found between the 4 groups. PFVs/PFVd was significantly reduced only in INF + POS compared with those in ANT, EAP, and VAP (1.39 +/- 0.05 vs. 1.75 +/- 0.08, 1.76 +/- 0.09, and 1.62 +/- 0.09, p less than 0.05, respectively). These results suggested that INF + POS caused impairment of the right atrial reservoir function.