Estimation of left ventricular diastolic pressures from precordial pulsed-Doppler analysis of pulmonary venous and mitral flow

Brunazzi, Maria Cristiana; Chirillo, Fabio; Pasqualini, Mario; Gemelli, M; Franceschini-Grisolia, Enrico; Longhini, C; Giommi, Luigi; Barbaresi, F; Stritoni, P

doi:10.1016/0002-8703(94)90482-0

Cited by 97 publications

(24 citation statements)

References 43 publications

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“…Transmitral parameters have been shown to be useful in patients with LV systolic dysfunction. 5,[31][32][33][34] The present study confirms that DT and the E/A ratio correlate with LV filling pressure when EF Ͻ50%. However, healthy ventricles that maintain early diastolic suction forces may also manifest a relatively short DT and high E/A ratio.…”

Section: Discussionsupporting

confidence: 85%

“…3,4 To overcome these limitations of the mitral inflow parameters, combinations of the mitral flow velocity curves with other Doppler parameters have been used. These include the pulmonary venous velocity curves, [5][6][7][8][9][10] color M-mode, 11,12 and the response of the mitral inflow to altered loading conditions. 13,14 Tissue Doppler imaging (TDI) of mitral annular motion has been proposed to correct for the influence of myocardial relaxation on transmitral flows.…”

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confidence: 99%

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Clinical Utility of Doppler Echocardiography and Tissue Doppler Imaging in the Estimation of Left Ventricular Filling Pressures

et al. 2000

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Section: Discussionsupporting

confidence: 85%

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confidence: 99%

Clinical Utility of Doppler Echocardiography and Tissue Doppler Imaging in the Estimation of Left Ventricular Filling Pressures

et al. 2000

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“…32 Short DTs nearly always indicate a mean left atrial mean pressure Ͼ25 mm Hg. Because BNP is a reliable indicator of elevated LV pressure, 7 one would assume that correlations of BNP to restrictivelike filling patterns would be high.…”

Section: Lubien Et Al Bnp Utility In Screening For Diastolic Dysfunctmentioning

confidence: 99%

Utility of B-Natriuretic Peptide in Detecting Diastolic Dysfunction

et al. 2002

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Background-Although Doppler echocardiography has been used to identify abnormal left ventricular (LV) diastolic filling dynamics, inherent limitations suggest the need for additional measures of diastolic dysfunction. Because data suggest that B-natriuretic peptide (BNP) partially reflects ventricular pressure, we hypothesized that BNP levels could predict diastolic abnormalities in patients with normal systolic function. Methods and Results-We studied 294 patients referred for echocardiography to evaluate ventricular function. Patients with abnormal systolic function were excluded. Cardiologists making the assessment of LV function were blinded to BNP levels. Patients were classified as normal, impaired relaxation, pseudonormal, and restrictivelike filling patterns.Patients diagnosed with evidence of abnormal LV diastolic function (nϭ119) had a mean BNP concentration of 286Ϯ31 pg/mL; those in the normal LV group (nϭ175) had a mean BNP concentration of 33Ϯ3 pg/mL. Patients with restrictivelike filling patterns on echocardiography had the highest BNP levels (408Ϯ66 pg/mL), and patients with symptoms had higher BNP levels in all diastolic filling patterns. The area under the receiver-operating characteristic curve for BNP to detect any diastolic dysfunction was 0.92 (95% CI, 0.87 to 0.95; PϽ0.001). A BNP value of 62 pg/mL had a sensitivity of 85%, a specificity of 83%, and an accuracy of 84% for detecting diastolic dysfunction. Conclusions-A rapid assay for BNP can reliably detect the presence of diastolic abnormalities on echocardiography. In patients with normal systolic function, elevated BNP levels and diastolic filling abnormalities might help to reinforce the diagnosis diastolic dysfunction. (Circulation. 2002;105:595-601.)

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“…The sampling volume was placed near the tips of the mitral leaflets in order to measure the mitral inflow velocities [2]. The following parameters of diastolic function were evaluated: peak mitral flow velocity in early diastole (m/s); peak mitral flow velocity at atrial contraction (m/s); ratio of peak mitral flow velocity in early diastole and peak mitral flow velocity at atrial contraction; acceleration time (ms); deceleration time (ms) and isovolumetric relaxation time (ms).…”

Section: Clinical Examinationmentioning

confidence: 99%

“…[Diabetologia (2003) 46:267-275] Keywords Diastolic function, pregnancy, Type 1 diabetes mellitus, echocardiography. namic parameters in the maternal cardiovascular system were evaluated noninvasively by echocardiography [2,3]. In earlier studies, echocardiography was frequently applied in order to describe left ventricular systolic function and cardiac haemodynamics during pregnancy [1,4,5,6,7,8], since it allows assessment of cardiac haemodynamics without endangering the pregnancy.…”

Section: Introductionmentioning

confidence: 99%

Alterations of left ventricular function in women with insulin-dependent diabetes mellitus during pregnancy

et al. 2003

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Aims/hypothesis. During pregnancy, eminent cardiovascular changes occur. The aim of the following study was to investigate the course of haemodynamic parameters under the increased volume load during pregnancy and delivery in women with insulin-dependent diabetes mellitus. Methods. We examined 51 pregnant diabetic women and 51 healthy pregnant women. The control group consisted of 51 healthy non-pregnant women. In all women, left ventricular mass and fractional shortening were calculated. To evaluate left ventricular diastolic function, mitral inflow and pulmonary venous flow profiles were analysed. Results. During pregnancy left ventricular mass increased, fractional shortening decreased and diastolic dysfunction was found. While the healthy pregnant women developed signs of disturbed relaxation during pregnancy, pregnant diabetic women showed signs of a disturbed relaxation at the beginning of gestation. Of the pregnant diabetic women, 29 developed a restrictive filling pattern at the 24th week of gestation. The remaining 22 diabetic women had a comparable restrictive filling pattern only during vaginal delivery. In 10 of the 29 pregnant diabetic women dangerous complications were documented, while there were no complications in the healthy pregnant women and the other 22 diabetic pregnant women. Conclusion/interpretation. In healthy women pregnancy results in a reversible physiologic left ventricular hypertrophy, a disturbed relaxation pattern and a temporary decrease of left ventricular systolic function. In contrast, pregnant diabetic women showed a delayed relaxation at the beginning of pregnancy and developed a restrictive filling pattern. The early development of a restrictive filling pattern could indicate complications during delivery in pregnant diabetic women. [Diabetologia (2003) 46:267-275] Keywords Diastolic function, pregnancy, Type 1 diabetes mellitus, echocardiography. namic parameters in the maternal cardiovascular system were evaluated noninvasively by echocardiography [2,3]. In earlier studies, echocardiography was frequently applied in order to describe left ventricular systolic function and cardiac haemodynamics during pregnancy [1,4,5,6,7,8], since it allows assessment of cardiac haemodynamics without endangering the pregnancy. However little data on left ventricular diastolic function during pregnancy has been assessed. Our own working group was able to show that an uncomplicated pregnancy in healthy women with normal left ventricular function causes reversible haemodynamic changes with a passager restrictive filling pattern at delivery [8]. In patients with insulin-dependent Pregnancy causes haemodynamic changes in the cardiovascular system due to the physiological volumeoverload [1]. In former studies, changes in haemody-

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Estimation of left ventricular diastolic pressures from precordial pulsed-Doppler analysis of pulmonary venous and mitral flow

Cited by 97 publications

References 43 publications

Clinical Utility of Doppler Echocardiography and Tissue Doppler Imaging in the Estimation of Left Ventricular Filling Pressures

Clinical Utility of Doppler Echocardiography and Tissue Doppler Imaging in the Estimation of Left Ventricular Filling Pressures

Utility of B-Natriuretic Peptide in Detecting Diastolic Dysfunction

Alterations of left ventricular function in women with insulin-dependent diabetes mellitus during pregnancy

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