Pulmonary venous flow reversal exceeding mitral A wave duration predicted left ventricular end-diastolic pressure >15 mm Hg with a sensitivity of 0.85 and specificity of 0.79.
Observational (n=50)
Does transthoracic Doppler ultrasound measurement of pulmonary venous flow variables identify patients with elevated left ventricular end-diastolic or filling pressures?
Transthoracic Doppler ultrasound measurement of pulmonary venous flow variables can reliably identify patients with elevated left ventricular end-diastolic and filling pressures.
Effect estimate: Sensitivity 0.85, Specificity 0.79
p-value: p=< 0.001
OBJECTIVES: This study was conducted to investigate whether pulmonary venous flow variables measured by transthoracic Doppler ultrasound can help identify patients with elevated left ventricular end-diastolic or filling pressures, or both. BACKGROUND: A widened left atrial pressure A wave occurs when left ventricular end-diastolic pressure is increased. Increased duration of pulmonary venous flow reversal at atrial systole might therefore be a marker for elevated end-diastolic pressure. Decreased systolic pulmonary venous flow is shown to be related to increased left ventricular filling pressure in studies using transesophageal Doppler echocardiography. METHODS: Left ventricular pressures at late diastole were measured by fluid-filled catheters in 50 consecutive patients undergoing diagnostic cardiac catheterization. Pulmonary venous and mitral flow velocities were recorded by transthoracic pulsed Doppler ultrasound. RESULTS: Adequate recordings were obtained in 45 patients. Pulmonary venous flow reversal exceeding the duration of the mitral A wave predicted left ventricular end-diastolic pressure > 15 mm Hg with a sensitivity of 0.85 and a specificity of 0.79. This difference in flow duration correlated well with the increase in ventricular pressure (r = 0.70, p 18 mm Hg. CONCLUSIONS: Pulmonary venous flow reversal exceeding the duration of the mitral A wave indicates an exaggerated increase in left ventricular late diastolic pressure. Pulmonary venous systolic fraction < 0.4 suggests markedly increased ventricular filling pressure.
Rossvoll et al. (1993) conducted an observational in Elevated left ventricular diastolic pressures (n=50). Pulmonary venous flow velocities recorded by transthoracic Doppler ultrasound vs. Left ventricular pressures measured by fluid-filled catheters was evaluated on Prediction of left ventricular end-diastolic pressure > 15 mm Hg (Sensitivity 0.85, Specificity 0.79, p=< 0.001). Pulmonary venous flow reversal exceeding mitral A wave duration predicted left ventricular end-diastolic pressure >15 mm Hg with a sensitivity of 0.85 and specificity of 0.79.