[V1P-terminal force evaluated by left ventricular inflow velocity patterns in pulsed Doppler echocardiography]

The relationship between V1P-terminal force (V1-PT) and the characteristics of left ventricular (LV) diastolic filling and atrial contraction were evaluated using LV inflow velocity patterns obtained by pulsed Doppler echocardiography. Subjects consisted of 54 patients with old myocardial infarction, 56 with essential hypertension, 48 with angina pectoris, 19 with dilated cardiomyopathy, and 16 with miscellaneous disease other than of mitral valve lesions. The patients were classified as the positive group: V1-PT less than or equal to -0.04 mmsec, intermediate group: 0 greater than V1-PT greater than -0.04 mmsec, and negative group: V1-PT greater than or equal to 0 mmsec. The following were the results obtained: 1. In the positive group, the rapid filling wave (R) had reduced velocity, the prolonged deceleration time and the decreased acceleration and deceleration ratios. 2. In the positive group, velocity of the atrial contraction wave (A) was increased and the atrial contraction time was prolonged compared to the other groups. 3. In the positive group, the A/R was greater than in the other groups. 4. In the positive and intermediate groups, V1-PT correlated significantly with the A/R (r = 0.83, p less than 0.01), R (r = -0.58, p less than 0.01) and A (r = 0.48, p less than 0.01). In the positive group, LV inflow volume was decreased in the rapid filling phase. In the atrial contraction phase, the inflow volume was increased to compensate for loss of inflow volume in the rapid filling phase. These findings suggested that LV diastolic filling was disturbed in the positive group. In conclusion, the value of V1-PT is influenced by any disturbance of LV diastolic filling.