Accuracy of Doppler ultrasound in evaluating changes of left ventricular diastolic properties.
In order to evaluate the effect of an increase in preload caused by contrast medium (Renografin-75) on Doppler echocardiographic indices of left ventricular diastolic properties, left ventricular pressure using a catheter tip micromanometer and pulsed-Doppler measurement of transmitral flow signals were measured simultaneously in 15 patients with coronary artery disease pre- and post-left ventricular angiography.  After left ventricular angiography, changes in indices determined from left ventricular pressure were significant: left ventricular end-diastolic pressure increased from 17 +/- 2 mmHg to 24 +/- 2 mmHg (mean +/- SE) (P less than 0.001), maximum -dP/dt increased from 1,129 +/- 63 to 1,307 +/- 90 mmHg/sec (P less than 0.005), and time constant decreased from 73 +/- 2 to 67 +/- 1 msec (P less than 0.01).  Changes in Doppler-derived indices were also significant: A/E ratio decreased from 0.99 +/- 0.08 to 0.81 +/- 0.07 (P less than 0.01), peak velocity of early diastolic filling increased from 0.61 +/- 0.03 to 0.79 +/- 0.03 M/sec (P less than 0.01), and deceleration rate increased from 3.1 +/- 0.2 to 4.6 +/- 0.2 M/sec 2 (P less than 0.01). Changes in Doppler echocardiographic indices (DR, acceleration half time, deceleration half time, and A/E ratio) were accompanied by changes in time constant and maximum -dP/dt after left ventricular angiography.  However, the correlations between changes in hemodynamic indices and changes in Doppler echocardiographic indices were poor (r = 0.06 to 0.67).(ABSTRACT TRUNCATED AT 250 WORDS)
Department of Medicine, LAC-USC Medical Center, Los Angeles, CA 90033.
S
S
Lin
T
T
Tak
D T
DT
Kawanishi
S H
SH
Rahimtoola
P A
PA
Chandraratna
D000328:Adult; D000368:Aged; D001794:Blood Pressure; D006328:Cardiac Catheterization; D003287:Contrast Media; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000503:physiopathology; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016277:Ventricular Function, Left / Q000502:physiology*