Estimation of Left Ventricular End-Diastolic Pressure by Pulsed Doppler Ultrasound

Channer, Kevin S.; Wilde, Peter; Culling, W.; Jones, J V

doi:10.1016/s0140-6736(86)91273-0

Cited by 77 publications

(17 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Regional dysfunction is common and is a limitation when using FS as an indicator of systolic left ventricular function in patients with 1HD. Nonetheless, FS has been successfully used to evaluate individual changes in left ventricular function in follow-up studies of patients with IHD [6,7], and M-mode echocardiography is very useful in the diagnostic evaluation of patients with suspected heart failure, especially for the exclusion of heart failure [8], Indices of diastolic function, achieved with Doppler echocardiography, correlate well with those obtained with cardiac catheterization [9] and radionu clide angiography [10], Attention has also been focused on cardiac changes not related to disease but to such vari ables as age and gender [ 1. 11],…”

Section: Introductionmentioning

confidence: 99%

Age and Gender Differences in Left Ventricular Function among Patients with Stable Angina and a Matched Control Group

Eriksson

Björkander²,

Held³

et al. 1996

Cardiology

View full text Add to dashboard Cite

To assess left ventricular systolic and diastolic function, M-mode (n = 675) and transmitral Doppler echocardiography (n = 358) were performed in patients with stable angina pectoris and compared with 50 matched healthy controls. Left ventricular fractional shortening (FS) was significantly lower in male than in female patients (32 ± 7 vs. 35 ± 7%, p < 0.001). A history of heart failure was as frequent in men (6%) as in women (6%), but left ventricular systolic dysfunction was more frequent in men than in women (25 vs. 12%, p < 0.005). The ratio of early/late diastolic peak flow velocity (E/A ratio) was significantly lower, indicating diastolic dysfunction, in female patients with clinical heart failure than in those without (0.79 ± 0.25 vs. 1.02 ± 0.3, p < 0.05). No such difference was found in male patients. Inverse relationships were found between age and E/A ratio in both controls (r = -0.45, p < 0.001) and angina patients (r = -0.44, p < 0.001). Thus, despite similar frequency of clinical heart failure, left ventricular systolic dysfunction was more common in men than in women with stable angina.

show abstract

Section: Introductionmentioning

confidence: 99%

Age and Gender Differences in Left Ventricular Function among Patients with Stable Angina and a Matched Control Group

Eriksson

Björkander²,

Held³

et al. 1996

Cardiology

View full text Add to dashboard Cite

show abstract

“…This alternative technique requires the knowledge of LV EDP, which can be noninvasively obtained using several previously validated methods (3,19,21). In this study, we used the technique described by Olariu et al based on dtPVFd, which was validated against invasive measurements in a large group of patients (21).…”

Section: Discussionmentioning

confidence: 99%

Noninvasive quantification of left ventricular elastance and ventricular-arterial coupling using three-dimensional echocardiography and arterial tonometry

Gayat

Mor‐Avi

Weinert

et al. 2011

American Journal of Physiology-Heart and Circulatory Physiology

View full text Add to dashboard Cite

Gayat E, Mor-Avi V, Weinert L, Yodwut C, Lang RM. Noninvasive quantification of left ventricular elastance and ventricular-arterial coupling using three-dimensional echocardiography and arterial tonometry. Am J Physiol Heart Circ Physiol 301: H1916-H1923, 2011. First published September 9, 2011; doi:10.1152/ajpheart.00760.2011.-Most techniques previously used to assess left ventricular (LV) end-systolic elastance (E es) and ventricular-arterial coupling (CLV-A) relied on invasive measurements and data acquisition over a wide range of loading conditions. Our goals were to 1) assess the feasibility of noninvasive assessment of E es and CLV-A using real-time three-dimensional echocardiography (RT3DE) and arterial tonometry; 2) test the ability of this approach to detect changes in LV contractility; and 3) study its reproducibility. We studied pharmacologically induced changes in inotropic state (5 and 10 g·kg Ϫ1 ·min Ϫ1 dobutamine) in normal volunteers (N ϭ 8) and compared 10 normal volunteers with 10 patients with dilated cardiomyopathy (DCM; ejection fraction Ͻ 35%). RT3DE LV images, calibrated carotid artery tonometry, and Doppler tracings were obtained to noninvasively estimate Ees and CLV-A, using two alternative calculations. Dobutamine caused a significant stepwise increase in blood pressure, heart rate, ejection fraction, and Ees and a decreased CLV-A. In patients with DCM, Ees was significantly reduced and CLV-A elevated, compared with controls. Both inter-and intraobserver variability were good for all measured parameters, as reflected by intraclass correlation coefficients (Ͼ0.8) and coefficients of variation (Ͻ20%). While both Ees estimates showed significant differences between DCM patients and controls, one estimate resulted in no overlap and better reproducibility (interobserver intraclass correlation coefficient: 0.83 vs. 0.47, coefficients of variation: 20 vs. 29%). This is the first study to test the feasibility of using RT3DE-derived LV volumes in conjunction with arterial tonometry to noninvasively quantify LV elastance and CLV-A. This approach was found to be sensitive enough to detect expected differences in LV contractility and reproducible. Due to its noninvasive nature, this methodology may have clinical implications in various disease states. left ventricular contractility LEFT VENTRICULAR (LV) pressure-volume loops provide valuable information on LV systolic and diastolic function, as well as on LV-arterial coupling (C LV-A ) (8). End-systolic elastance (E es ), the slope of the end-systolic pressure (ESP)-volume relationship, has been used as a load-independent index of myocardial contractility (2). In the past, to obtain pressure-volume loops, invasive pressure and volume measurements were required to be obtained under a wide range of loading conditions, thus limiting the clinical applicability of this technique. To avoid these limitations, several investigators have proposed invasive solutions to estimate E es from a single cardiac cycle (23,24,27), and, more recently, the accuracy of ...

show abstract

“…Recently, some investigators have reported a negative relationship between the atrial contribution to ventricu lar filling and the pulmonary artery wedge pressure [15][16][17][18]. The Doppler-derived transmitral flow velocity pro file in the hemodialysis patients with elevated left ven tricular preload was very similar to that of the normal controls and should be termed a 'pseudonormalized' pat tern.…”

Section: Comparison With the Normal Controlsmentioning

confidence: 95%

“…However, this pattern was not always observed in patients with severely depressed cardiac function [13], Recently, Ishida et al [14] have reported the impor tant role of left atrial pressure in determining left ven tricular filling dynamics. However, few papers have dis cussed the influences of left ventricular preload on the transmitral flow velocity profile in humans [15][16][17][18]. A clear understanding of these effects is necessary for the…”

mentioning

confidence: 99%

Influence of Left Ventricular Preload Reduction by Hemodialysis on the Doppler-Derived Left Ventricular Filling Profile

Miyaguchi¹,

Iwase²,

Yokota³

et al. 1990

Am J Noninvas Cardiol

View full text Add to dashboard Cite

The influence of left ventricular preload alterations on left ventricular diastolic filling was examined by performing M mode and pulsed Doppler echocardiography in 18 patients with chronic renal failure both before and after hemodialysis. Hemodialysis caused an average 3.2-liter volume loss, but blood pressure and heart rate did not change significantly. Hemodialysis diminished the left atrial dimension (35 ± 5 to 31 ± 5 mm; p < 0.001) and the left ventricular end-diastolic dimension (55 ± 6 to 50 ± 5 mm; p < 0.01), indicating that it reduced left ventricular preload. Although hemodialysis decreased both the peak velocity during rapid filling (R; 54 ± 10 to 36 ± 11 cm/s; p < 0.001) and the peak velocity during atrial contraction (A; 68 ± 9 to 58 ± 10 cm/s; p < 0.001), it increased the A/R ratio (1.29 ± 0.24 to 1.71 ± 0.41; p < 0.001) substantially. Reduction of uremic toxins and/or correction of electrolyte imbalances might be expected to improve both left ventricular relaxation and systolic function. However, following left ventricular preload reduction after hemodialysis, the Doppler-derived transmitral flow velocity profile mimicked previously reported patterns of impaired diastolic function. These results indicate that the atrial contribution to ventricular filling was more effective afterwards than before hemodialysis and that under depressed left ventricular diastolic function, the atrial contribution decreased as preload increased further. This decrease in the A/R ratio with an elevation of left ventricular preload could be termed ‘pseudonormalization’ of the transmitral flow velocity profile. To differentiate this ‘pseudonormalized’ profile from a truly normal one, left ventricular preload must be considered.

show abstract

Estimation of Left Ventricular End-Diastolic Pressure by Pulsed Doppler Ultrasound

Cited by 77 publications

References 7 publications

Age and Gender Differences in Left Ventricular Function among Patients with Stable Angina and a Matched Control Group

Age and Gender Differences in Left Ventricular Function among Patients with Stable Angina and a Matched Control Group

Noninvasive quantification of left ventricular elastance and ventricular-arterial coupling using three-dimensional echocardiography and arterial tonometry

Influence of Left Ventricular Preload Reduction by Hemodialysis on the Doppler-Derived Left Ventricular Filling Profile

Contact Info

Product

Resources

About