[Determinants of mitral inflow velocity profiles in relation to left ventricular volume change: evaluations by pulsed Doppler echocardiography and left ventriculography].
We evaluated relationships between pulsed Doppler echocardiographic (PDE) parameters of flow velocity profiles across the mitral orifice and left ventriculographic (LVG) parameters of left ventricular volume changes. Subjects consisted of 19 patients with coronary artery disease and 12 patients with chest pain syndrome. Peak flow velocities at the rapid filling (E) and atrial contraction (A) were measured by PDE. Time constant of left ventricular relaxation (T), left ventricular minimum pressure (LVPmin), LV end-diastolic pressure (LVEDP) and pulmonary capillary wedge V wave pressure (PCW-V) were measured during cardiac catheterization. From the analysis of LVG, the rapid filling fraction (RFF), and the atrial filling fraction (AFF) were obtained. The left ventricular chamber stiffness (K) was identified by the analysis of the pressure-volume relationship of the left ventricle. We investigated the relationship between A/E and AFF/RFF by univariate linear regression analysis. We then performed stepwise multivariate linear regression analysis to predict E, A, A/E, RFF, AFF and AFF/RFF by the variables of left ventricular filling, i.e., T, LVPmin, LVEDP, PCW-V, K, heart rate (at the examination of PDE or LVG), mean arterial blood pressure (at PDE or LVG) and age. The A/E correlated significantly with AFF/RFF (r = 0.50, p < 0.01). The results of the multivariate linear regression analyses were as follows: [sequence: see text] The correlation of A/E and AFF/RFF were explained by some variables, except the variable T. The results of uni- and multivariate linear regression analyses showed that factors affecting the flow velocity profile across the mitral orifice did not account for the left ventricular volume changes. We also observed that, even in subjects with coronary heart disease, aging is a main factor that influences peak flow velocity at atrial contraction (A).
Ohte
N
N
Third Department of Internal Medicine, Nagoya City University Medical School.
Hashimoto
T
T
Narita
H
H
Takase
R
R
Nakano
S
S
Fujinami
T
T
D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000503:physiopathology; D001783:Blood Flow Velocity; D006328:Cardiac Catheterization; D002306:Cardiac Volume; D003327:Coronary Disease / Q000503:physiopathology; D015150:Echocardiography, Doppler; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D008875:Middle Aged; D008943:Mitral Valve / Q000502:physiology*; D011669:Pulmonary Wedge Pressure; D011859:Radiography; D012044:Regression Analysis; D013318:Stroke Volume; D016277:Ventricular Function, Left / Q000502:physiology*