Normal Pulmonary Venous Flow Characteristics as Assessed by Transesophageal Pulsed Doppler Echocardiography

Meijburg, Huub W.; Visser, Cees A.; Westerhof, P. W.; Kasteleyn, Ineke; Tweel, Ingeborg van der; Medina, Etienne O. Robles de

doi:10.1016/s0894-7317(14)80324-6

Cited by 35 publications

(15 citation statements)

References 34 publications

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“…In human medicine, the influence of respiration on pulmonary venous flow as assessed by transthoracic or transesophageal echocardiography has been reported as trivial [5,7]. In our study, the peak velocity and the VTI of the PVF in anesthetized dogs showed a significant decrease during inspiration in comparison with the value obtained at expiratory duration.…”

supporting

confidence: 44%

“…Recently, using transesophageal pulsed Doppler echocardiography to assess the pulmonary venous flow (PVF) has become a widely accepted new method to help evaluate left ventricular diastolic function of various cardiac diseases in human medicine [5,14]. It has been reported that there are several influential factors, such as heart rate and respiration, in the analysis of the PVF [7,12]. In human medicine, the variable of the PVF recorded during the expiratory period is assessed routinely, since it is reported that the change in intrathoracic pressure during respiration may affect the value of the PVF.…”

mentioning

confidence: 99%

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Effects of Respiratory Cycle on Pulmonary Venous Flow and Cardiac Cycle on Pulmonary Venous Diameter of Dogs: A Transesophageal Echocardiography Study.

Chiang

Hagio

Okano

1999

The Journal of Veterinary Medical Science

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ABSTRACT. We investigated 12 anesthetized normal dogs using transesophageal echocardiography to understand the effects of respiration on the pulmonary venous flow. Additionally, we observed whether the diameter of the pulmonary vein changes with the heart beat. The pulsed Doppler wave form of pulmonary venous flow predominantly demonstrated two backward flows, with one peak occurring during ventricular systole and another during ventricular diastole. Sometimes a small forward flow occurred during left atrial contraction. In comparison with expiration, the peak velocity and velocity-time integral of the flow wave under inspiration occurred during both systole and diastole were significantly smaller. The diameter of the pulmonary vein decreased during left atrial contraction and increased during left ventricular systole and diastole.-KEY WORDS: canine, pulmonary venous diameter, pulmonary venous flow.J. Vet. Med. Sci. 61(2): 155-158, 1999 physical examination and hematology, and the ages were estimated among 1 to 3 years old according to previous report [4]. There was no evidence of cardiac or pulmonary abnormality based on either auscultation or two-dimensional echocardiography. No Dirofilaria immitis infection was identified by microfilarial detection and immunodiagnostic test (VetRED ® , AGEN Biomedical). These dogs were anesthetized for insertion of the transesophageal probe. The anesthetic protocol included premedication with atropine (0.025 mg/kg, IM) and droperidol (0.5 mg/kg, IV), induction with pentobarbital sodium (20 mg/kg, IV), and maintenance with halothane (1-1.5%) under spontaneous respiration. The dog was initially examined at left lateral recumbency. A 5 MHz biplane transesophageal probe (EUP-ES322, Hitachi Medical Corporation) connected to an ultrasound instrument (EUB-565A, Hitachi Medical Corporation) was navigated according to the method reported by Loyer and Thomas [6]. With the transesophageal probe in an unflexed position, the imaging plane was switched to transverse plane, and the probe was advanced into the stomach until the liver image was visible on the screen. The denominated middle position was achieved by slowly withdrawing and slightly flexing the probe from the stomach to a position just caudal to the point where interference by the trachea was encountered. In this position the probe was located caudal to the tracheal bifurcation and dorsal to the left atrium, between the cranial and caudal pulmonary veins.To observe the caudal pulmonary veins, we slightly advanced the probe again to a position between the right and left caudal pulmonary veins ( Fig. 1-A). This position was located between the middle and the caudal position that was described by Loyer and Thomas. The imaging plane was maintained in transverse plane to produce a long-axis four chamber view. To reduce the angle between the PVF and the Doppler sampling beam, we rotated the probe clockwise enough for adequate right caudal lobe PVF recording with pulsed Doppler mode ( Fig. 1-B). In addition,

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supporting

confidence: 44%

mentioning

confidence: 99%

Effects of Respiratory Cycle on Pulmonary Venous Flow and Cardiac Cycle on Pulmonary Venous Diameter of Dogs: A Transesophageal Echocardiography Study.

Chiang

Hagio

Okano

1999

The Journal of Veterinary Medical Science

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“…Care was taken that all patients were evaluated only after consideration of a fluid challenge on cardiac output. Simultaneously with the continuous measurement of invasive pressures (Sirecust 961, Siemens, Germany), TEE measurements were performed (Aloka SSD-830, Tokyo, Japan) at three levels, as described previously [11]: a) a midpapillary short axis view of the LV (in order to measure end-systolic and end-diastolic areas); at the levels of both b) the mitral valve and c) the right upper pulmonary vein.…”

Section: Methodsmentioning

confidence: 99%

Left ventricular systolic and diastolic function in septic shock

Poelaert¹,

Declerck²,

Vogelaers³

et al. 1997

Intensive Care Medicine

233

121

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Notwithstanding the known various interfering factors which limit the broad applicability of TEE to determine LV function in septic shock, our data suggest that cardiac dysfunction in septic shock shows a continuum from isolated diastolic dysfunction to both diastolic and systolic ventricular failure. These data strengthen the need of including the evaluation of pulmonary venous Doppler parameters in each investigation in order to obtain supplementary information to interpret diastolic function of the LV in septic shock patients.

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“…The similar respiratory effects on the pulmonary venous flow were also demonstrated in one study using transesophageal pulsed Doppler echocardiography. In addition, this study showed that compared to the spontaneous respiration, Valsalva maneuver has greater impacts on the pulmonary venous flow (Meijburg et al, 1992). These effects should be considered when the pulmonary venous Doppler variables are applied for clinical purposes, and it would be of importance if considering the respiratory variation of the pulmonary venous flow when adopting PVs/ PVd to identify pseudonormal left ventricular function.…”

Section: Discussionmentioning

confidence: 86%