Circulation Journal Official Journal of the Japanese Circulation Society http://www. j-circ.or.jp nalysis of the transmitral inflow (TMF) and of the tissue Doppler imaging (TDI)-derived mitral annular velocities is commonly used for evaluating left ventricular (LV) filling pressure, 1,2 and these measures provide valuable information for the management of patients with heart failure (HF) and sinus rhythm. In particular, the ratio of the early transmitral peak velocity to the early mitral annular velocity (E/e'), which is used for evaluating LV filling pressure, is widely used in the clinical setting. The E/e' range from 8 to 15 is recognized as a gray or indeterminate zone for the estimation of LV filling pressure. 2,3 Furthermore, the measurement of the time interval between the onset of E and the onset of e' (TE-e') has been proposed as another calculation using E and e' that can predict LV filling pressure. 4-9 In addition, the clinical utility of TE-e' in patients with normal systolic function and an indeterminate E/e' has been reported. 10 In contrast, the utilization of TMF and TDI pattern analysis in patients with atrial fibrillation (AF) has not been established because of the lack of atrial contraction and variability of the heart rate. Recently, the usefulness of the simultaneous recording of the ratio of early transmitral peak velocity to flow propagation velocity (E/Vp) and E/e', using a dual Doppler system, for the assessment of LV filling pressure in patients with AF was reported. 11-13 The usefulness of TE-e' obtained by simultaneous recording of the onset of E and e' for the assessment of LV filling pressure in patients with AF, however, was not evaluated.The purpose of the present study was therefore to investigate the following: (1) the usefulness of TE-e' in patients with AF for the assessment of LV filling pressure using the simultaneous recording of TMF and TDI with a dual Doppler system; and (2) the added benefit of using TE-e' to predict LV filling pressure, in addition to the measurement of E/e'. The time interval between the onset of early transmitral flow velocity (E) and that of early diastolic mitral annular velocity (e') (TE-e') is a good predictor of elevated left ventricular (LV) filling pressure in patients with sinus rhythm. Although the evaluation of LV filling pressure using E/e' has been challenging in atrial fibrillation (AF), the usefulness of TE-e' is unknown.

Two-dimensional Doppler scanning revealed a significant increase in the mean and peak velocities in the soleal and popliteal veins with SFC-IPC but not with IF-IPC in patients with CHF. These results indicate that SFC-IPC could have favorable effects in preventing DVT in patients with CHF.

IOTEE provides important intraoperative and postoperative information that may influence surgical decision-making in various cardiovascular surgeries.

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