Mitral flow velocity patterns assessed by Doppler echocardiography correlate with hemodynamic status and myocardial function, offering a noninvasive assessment of left ventricular diastolic function.
Observational (n=100)
Can clinically useful information regarding left ventricular diastolic function be inferred noninvasively with pulsed wave Doppler echocardiography compared to invasive hemodynamics?
Doppler echocardiography of mitral flow velocity provides a noninvasive, dynamic assessment of left ventricular diastolic function, though patterns can be confounded by elevated left atrial pressure.
In an effort to determine what clinically useful information regarding left ventricular diastolic function can be inferred noninvasively with pulsed wave Doppler echocardiography, mitral flow velocity patterns and measured variables were correlated with hemodynamic findings in 70 patients: 30 with coronary artery disease, 20 with idiopathic congestive cardiomyopathy, 14 with a restrictive myocardial process and 6 without significant cardiac disease. The effect of sudden changes in hemodynamics on the mitral flow velocity pattern was also investigated in a subgroup of patients who had simultaneous recording of mitral flow velocity and left ventricular pressure before and after left ventriculography. Mitral flow velocity recordings from 30 healthy adults served as a reference group. This analysis suggests that 1) the majority of patients with these cardiac disorders demonstrate abnormal mitral flow velocity patterns or variables; 2) markedly different flow velocity patterns can be seen in patients with impaired left ventricular relaxation; 3) the different mitral patterns appear to relate more to myocardial function and hemodynamic status than to the type of disease process present; 4) certain mitral patterns suggest different filling pressures and rates of early diastolic left ventricular filling; 5) an increase in left atrial pressure can "normalize" an abnormal mitral flow velocity pattern and "mask" a left ventricular relaxation abnormality; and 6) the different patterns appear to represent a dynamic continuum with the potential to change from one to another as a result of disease progression, medical therapy or sudden changes in hemodynamics. It is concluded that, despite the indirect method of estimation and certain limitations, mitral flow velocity recordings have clinical potential in assessing left ventricular diastolic function that merits further investigation.
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Appleton et al. (Mon,) conducted a observational in Cardiac disorders (coronary artery disease, cardiomyopathy, restrictive myocardial process) (n=100). Pulsed wave Doppler echocardiography (mitral flow velocity patterns) vs. Hemodynamic findings was evaluated on Correlation of mitral flow velocity patterns with hemodynamic findings. Mitral flow velocity patterns assessed by Doppler echocardiography correlate with hemodynamic status and myocardial function, offering a noninvasive assessment of left ventricular diastolic function.