Interpretation of cardiac pathophysiology from pressure waveform analysis: the left-sided V wave.
The left-sided V wave is dependent on both left atrial and ventricular pressure/volume filling relationship. The cardiac rhythm and timing of atrial systole also influences the V wave. The morphology of the V wave can reflect the severity of mitral regurgitation with stenosis, but valve areas in this setting may be better assessed by a pressure half-time method. Finally, as queried in our first patient example, V wave alternans is a reflection of left ventricular pressure alternans in a failing heart. Other signs of poor left ventricular function in Figure 1 also included an elevated minimal diastolic pressure and markedly elevated left ventricular end diastolic pressure. Hemodynamic findings of poor left ventricular function will be addressed in detail in a later "Rounds."
Kern
M J
MJ
Cardiology Division, St. Louis University Hospital, Missouri 63110.
Deligonul
U
U
D000368:Aged; D016279:Atrial Function, Left / Q000502:physiology*; D006328:Cardiac Catheterization; D005260:Female; D006333:Heart Failure / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000175:diagnosis*; D008946:Mitral Valve Stenosis / Q000175:diagnosis*; D011669:Pulmonary Wedge Pressure / Q000502:physiology*; D011674:Pulse / Q000502:physiology; D016277:Ventricular Function, Left / Q000502:physiology*