Left Ventricular Ejection Time Derived From the Common Carotid Artery Doppler Waveform

Abstract

Objectives Left ventricular ejection time (LVET) is measured from blood pressure tracings as the interval from end diastole to the dicrotic notch and shows associations with left ventricular ejection fraction (LVEF) and heart failure. LVET can be measured on common carotid artery Doppler waveforms. We therefore studied the possible associations of common carotid artery LVET with LVEF measured by echocardiography and heart failure. Methods We performed a retrospective study of 110 patients who had transthoracic echocardiography and carotid Doppler evaluations within 1 day of each other. LVEF was determined by the biplane modified Simpson method. LVET was measured from left common carotid artery Doppler tracings. Linear regression was used to evaluate associations between LVET and LVEF. We also used logistic regression with LVEF of less than 40% as a cut point for heart failure to generate a receiver operating characteristic curve, estimate the area under the curve, and calculate sensitivity and specificity. Results LVET was associated with LVEF (P < .0001). The area under the curve of LVET for heart failure was 0.81 (95% confidence interval [CI], 0.72–0.87), and the sensitivity and specificity were 76.9% (95% CI, 65.4%–88.4%) and 65.5% (95% CI, 53.4%–77.8%), respectively, for LVET of 321 milliseconds. Conclusions LVET measured on common carotid artery Doppler tracings decreases with LVEF and is strongly associated with prevalent heart failure. Based on what is known of blood pressure–measured LVET, common carotid artery Doppler waveform–derived LVET could be used to serially monitor cardiac function.

Systolic time intervals derived from electrocardiographic gated intra-renal artery Doppler waveform associated with left ventricular systolic function

“…Unlike PEP, which respectively became shorten and lengthen by positive and negative inotropic agents, ET became shorten both by positive and negative inotropic agents3536. Although Polak et al showed ET measured from Doppler waveform of carotid artery was significantly associated with LVEF, they did not further evaluate their relationship by multivariate analysis14. In this study, all the parameters of renal STIs were correlated with LVEF and useful in prediction of LVEF <50% in the univaiable analyses.…”

“…Our previous study demonstrated that brachial PEP, brachial ET, and brachial PEP/ET measured from an automatic device were significant associated with LVEF13. Recently, Polak et al found ET measured from only Doppler waveform of carotid artery was also significantly associated with LVEF14. However, Polak et al did not investigate PEP and PEP/ET from arterial Doppler waveform.…”

Renal systolic time intervals derived from intra-renal artery Doppler as a novel predictor of adverse cardiac outcomes

“…An alternative parameter for evaluating cardiac systolic performance is STI20, Patients with decreased LVEF and left ventricular contractility have a long PEP, a shortened ET, and a long PEP/ET152021. Various STIs measured by non-invasive sphygmography, phonocardiography, peripheral arterial waveform recordings, or echocardiography reportedly have significant correlations with LVEF161722232425. Clinical applications of STI have been reported in various cardiac diseases, including heart failure, coronary artery disease, and hypertension142627.…”

The value of 2D speckle-tracking strain echocardiography in evaluating the relationship between carotid elasticity and left ventricular systolic function in patients with diabetic nephropathy

“…Conventional 2-D and Doppler echocardiography were carried out to exclude any unconfirmed structural disease of the heart including LV hypertrophy, valvular disease, pericardial disease, or cardiomyopathy. EF was obtained by biplane Simpson method [ 27 ]. Cine-loop clips of three consecutive cardiac cycles were obtained from the apical 4C, 2C, and 3C view.…”