Pulmonary venous flow patterns assessed by transesophageal pulsed doppler echocardiography in left atrial myxoma

Kisanuki, Akira; Shibata, Kunihiko; Kuroiwa, Ryuichi; Murayarna, Takashi; Matsushita, Ryoji; Nakao, Shoichiro; Nomoto, Kunihiro; Taira, Akira; Tanaka, Hiromitsu

doi:10.1016/0002-9149(93)90871-9

Cited by 8 publications

(7 citation statements)

References 13 publications

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“…The AR wave reflects atrial contraction (booster pump function) and increases in the situation of elevated LVEDP. There is also a distinct reversed wave during early systole (pulmonary venous flow at mitral valve closure: PVC) that is frequently observed in the presence of an elevated LA pressure, such as in the setting of mitral stenosis [22] or LA myxoma [23]. The PVC develops in the presence of elevated LA pressure during closure of the mitral valve resulting in regurgitant flow from the LA into the pulmonary veins where resistance is lower.…”

Section: Pulmonary Venous Flow Velocitiesmentioning

confidence: 99%

Diastology 2010: clinical approach to diastolic heart failure

Yamada

Klein

2010

J Echocardiogr

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The role of echocardiography in the evaluation of left ventricular diastolic function is increasingly important in both systolic and diastolic heart failure. In routine clinical practice, the diastolic dysfunction associated with diastolic heart failure can mainly be evaluated by Doppler echocardiography. In order to use echocardiographic techniques for this purpose, one should recognize the definition, terminology, epidemiology, and pathophysiology of diastolic dysfunction and diastolic heart failure. There are various echocardiographic parameters for this purpose, including transmitral flow velocity, pulmonary venous flow velocity, mitral annular velocity, flow propagation velocity, left atrial size, strain, strain rate, twist, and so on. However, no single Doppler echocardiographic index has yielded a robust criterion for diastolic dysfunction and elevated left ventricular filling pressure. Thus, multiple indices are required to increase the sensitivity of the diagnosis. Clinicians who take care of heart failure patients should continue to make critical use of a current Doppler echocardiographic evaluation and utilize this information to improve survival and quality of life in these patients.

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Section: Pulmonary Venous Flow Velocitiesmentioning

confidence: 99%

Diastology 2010: clinical approach to diastolic heart failure

Yamada

Klein

2010

J Echocardiogr

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“…In some patients, a reversed wave for the PVF velocity pattern (PVC) is transmitted from the LA to the pulmonary veins, which is consistent with mitral valve closure. In patients with an elevated LA pressure, such as patients with mitral stenosis or LA myxoma, the PVC is markedly accentuated [13,14].…”

Section: Basic Understandingmentioning

confidence: 99%

“…The reversed wave of the PVF velocity from the LA to the pulmonary veins (PVC) appears during closure of the mitral valve [13,14], and it must be distinguished from the PVA during atrial systolic phase. The PVC is a reversed wave related to the transmission of blood from the LA cavity to the pulmonary veins when the mitral valve is closing during end-diastole.…”

Section: Implication In Pulmonary Congestion With Reduced LV Ejectionmentioning

confidence: 99%

Renewed Interest in Left Atrial Function: What do we Need to Evaluate Clinically?

et al. 2005

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The use of a Swan-Ganz catheter has resulted in the accurate evaluation of the severity of acute left heart failure, making it possible to establish appropriate therapeutic strategies for this disorder using Forrester s classification. The routine use of clinical echocardiography has facilitated the noninvasive diagnosis of hemodynamic abnormalities related to various disease conditions. In particular, transmitral flow (TMF) and pulmonary venous flow (PVF) velocity patterns, acquired by the pulsed Doppler method, have led to the establishment of a new clinical field, diastology [1].Previously, the left ventricle (LV) was the focus of investigation when evaluating left heart function, and the left atrium (LA) was considered to have a minor supporting role. However, recent studies have focused on the role of the LA, because it has been recognized that a thorough understanding of LA performance is essential to evaluate more accurately left heart diseases [2]. When evaluating LV function clinically, hemodynamic abnormalities in the pulmonary vein-LA-LV relationship should always be considered, and echocardiography may be an indispensable tool for obtaining important information concerning the relationship between the pulmonary veins and LV with the LA playing a central role.In this review, we summarize how to evaluate LA function using echocardiography with the role of LA function in patients with left-side heart failure. Basic UnderstandingLeft atrial function is classified into 3 categories based on hemodynamic characteristics [3-6]: 1) reservoir function for blood returning from the pulmonary veins due to active relaxation and passive expansion of the LA during ventricular systole; 2) conduit function promoting direct blood inflow from the pulmonary veins to the LV during ventricular diastole; and 3) booster pump function that is responsible for active ejection of blood into the LV during atrial systole.The blood inflow from the pulmonary veins to the LA and that from the LA to the LV can be evaluated by pulsed Doppler echocardiography based on the PVF velocity pattern (Figure 1, PVF) and the TMF velocity pattern (Figure 1, TMF). Because LA filling and emptying are involved in the hemodynamic relationship between the pulmonary veins, LA and LV, the LA appendage flow velocity pattern (Figure 1, LAAF), recorded by pulsed Doppler echocardiography, and the mitral annular motion velocity pattern (Figure 1, MAMV), recorded by tissue Doppler imaging, also may be important indices for assessing LA function in addition to the LA size determined by M-mode and 2-and 3-dimensional echocardiography, which assess

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“…Previous reports [5,6] left atrial myxomas. The first, in patients with nonsignifi cant hemodynamic changes, is almost normal or, like that of mitral stenosis, is characterized by the following: (1) prolonged deceleration of the antegrade flow in diastole, and (2) well-represented antegrade flow during the entire systole [7], The second, in patients with significant hemo dynamic changes, is systolic flow inversion or decreased systolic flow velocity in the absence of mitral regurgita tion.…”

Section: Discussionmentioning

confidence: 96%

Role of Transesophageal Echocardiography in the Management of Metastatic Tumors Invading the Left Atrium

Lee¹,

Chen²,

Liau³

et al. 1997

Cardiology

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Two patients with metastatic tumors invading the left atrium are described. One is a 52-year-old woman with osteosarcoma; the other is a 77-year-old man with lung cancer. The first patient presented with severe dyspnea 1 year after treatment for a primary tumor. Cardiac metastasis was suspected, then documented by transesophageal echocardiography. The study of pulmonary vein flow showed decreased systolic forward and increased diastolic components of pulmonary venous flow. The second patient presented with chronic cough without dyspnea. Although a huge tumor invaded the left atrium, as in the first patient, a normal pattern of pulmonary vein flow with higher systolic than diastolic velocities was shown by transesophageal echocardiography. Thus, transesophageal echocardiography is not only a useful tool to diagnose left atrial metastatic tumors, but also the study of pulmonary venous flow patterns can delineate causes of dyspnea in patients with metastatic tumors invading the left atrium.

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Pulmonary venous flow patterns assessed by transesophageal pulsed doppler echocardiography in left atrial myxoma

Cited by 8 publications

References 13 publications

Diastology 2010: clinical approach to diastolic heart failure

Diastology 2010: clinical approach to diastolic heart failure

Renewed Interest in Left Atrial Function: What do we Need to Evaluate Clinically?

Role of Transesophageal Echocardiography in the Management of Metastatic Tumors Invading the Left Atrium

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