Author + information
- Received November 22, 1995
- Revision received June 7, 1996
- Accepted June 26, 1996
- Published online November 1, 1996.
- Rick A. Nishimura, MD, FACCa,**,
- Christopher P. Appleton, MD, FACC*,
- Margaret M. Redfield, MD, FACCa,
- Duane M. Ilstrup, MSa,
- David R. Holmes Jr., MD, FACCa and
- A. Jamil Tajik, MD, FACCa
- ↵**Address for correspondence: Dr. Rick A. Nishimura, Mayo Clinic, 200 First Street SW, Rochester, Minnesota 55905.
Objectives. The purpose of this study was to examine the relation of the mitral flow velocity curves to left ventricular filling pressures in patients with two different types of myocardial problems: hypertrophic cardiomyopathy and severe left ventricular systolic dysfunction.
Background. Previous studies have suggested that assessment of Doppler-derived mitral flow velocity curves can be used to predict left ventricular filling pressures in specific disease entities. However, it is unclear whether information derived from specific mitral flow velocity curves obtained from one disease entity can be valid in other disease states.
Methods. The study group consisted of 42 patients with left ventricular systolic dysfunction (group A) and 55 patients with hypertrophic cardiomyopathy (group B); both groups underwent simultaneous cardiac catheterization and were studied by Doppler echocardiography. High fidelity measures of left atrial and left ventricular pressures were obtained simultaneously with mitral flow velocity curves.
Results. There was a significant relation between the Doppler echocardiographic variables and mean left atrial pressure in group A patients. The left atrial pressure was directly related to the E/A ratio (r = 0.49, p = 0.004) and inversely related to the deceleration time (r = 0.73, p < 0.001). The sensitivity and specificity of the deceleration time, < 180 m/s, which indicated a mean left atrial pressure ≥20 mm Hg, were both 100%. In group B patients, there was no significant relation between mean left atrial pressure and deceleration time.
Conclusions. Doppler echocardiographic mitral flow velocity curves are useful in predicting and estimating left ventricular filling pressures in patients with left ventricular dysfunction. However, because of the complexity of the multiple interrelated factors that determine diastolic filling of the left ventricle, these flow velocity curves cannot be used in patients with other disease entities, such as hypertrophic cardiomyopathy. Future studies of different disease states are necessary to fully understand the role of Doppler echocardiography in the assessment of diastolic filling.
- Received November 22, 1995.
- Revision received June 7, 1996.
- Accepted June 26, 1996.
- American College of Cardiology