Author + information
- Received July 31, 2000
- Revision received February 16, 2001
- Accepted March 1, 2001
- Published online June 15, 2001.
- ↵*Reprint requests and correspondence: Dr. Tim Kinnaird, Department of Cardiology, London Chest Hospital, Bonner Road, London, United Kingdom, E2 9JX
This study compared a prediction of mean left atrial pressure (Pla) ascertained by Doppler echocardiography of pulmonary venous flow (PVF), with predicted Plausing the pulmonary artery occlusion pressure (Ppao).
In select patient groups, PVF variables correlate with Ppao, an indirect measure of Pla.
In 93 patients undergoing cardiac surgery, we recorded with transesophageal echocardiography mitral valve early (E) and late (A) wave velocities, deceleration time (DT) of E (DTe), and pulmonary vein systolic (S) and diastolic (D) wave velocities, DT of D (DTd) and systolic fraction. The Ppaowas measured using a pulmonary artery catheter zeroed to midaxillary level. A further catheter was held at midatrial level to zero a transducer and was then inserted into the left atrium. A prediction rule for Plafrom DTdwas developed in 50 patients and applied prospectively to estimate Plain 43 patients.
A close correlation (r = −0.92) was found between Plaand DTd. Systolic fraction (r = −0.63), DTe(r = −0.61), D wave (r = 0.57), E wave (r = 0.52), and E/A ratio (r = 0.13) correlated less closely with Pla. The mean difference between predicted and measured Plawas 0.58 mm Hg for DTdmethod and 1.72 mm Hg for Ppao, with limits of agreement (mean ± 2 SE) of −2.94 to 4.10 mm Hg and −2.48 to 5.92 mm Hg, respectively. A DTdof <175 ms had 100% sensitivity and 94% specificity for a Plaof >17 mm Hg.
Deceleration time of pulmonary vein diastolic wave is more accurate than Ppaoin estimating left atrial pressure in cardiac surgical patients.
- Received July 31, 2000.
- Revision received February 16, 2001.
- Accepted March 1, 2001.
- American College of Cardiology