title: Late-diastolic forward flow in the aorta induced by left atrial contraction.
abstract: Late-diastolic forward flow is a well-described phenomenon detectable by Doppler echocardiography in the pulmonary trunk. It is supported by a restrictive right ventricular diastolic function and by a low end-diastolic pulmonary artery pressure. A similar phenomenon for the left ventricle and the aorta has not been described. We report a case of a preterm infant with aortic stenosis and endocardial fibroelastosis, who underwent balloon valvuloplasty. Restrictive left ventricular diastolic filling led to high left atrial pressure (27 mm Hg) and a very pathologic ratio of early-to-late peak velocities (2.6) for an infant of 29 weeks' gestation. In combination with a low diastolic aortic pressure (24 mm Hg) caused by moderate aortic regurgitation after intervention, a late-diastolic forward flow was detectable in the aorta during left atrial contraction with pulsed Doppler echocardiography.
authors.affiliation: Department of Congenital Heart Diseases, German Heart Institute, Berlin, Germany. ewert@dhzb.de
authors.forename: P
authors.initials: P
authors.lastname: Ewert
authors.forename: N
authors.initials: N
authors.lastname: Nagdyman
authors.forename: I
authors.initials: I
authors.lastname: Daehnert
authors.forename: S
authors.initials: S
authors.lastname: Dittrich
authors.forename: H
authors.initials: H
authors.lastname: Abdul-Khaliq
authors.forename: F
authors.initials: F
authors.lastname: Berger
authors.forename: P E
authors.initials: PE
authors.lastname: Lange
mesh_terms: D001011:Aorta / Q000503:physiopathology*; D001024:Aortic Valve Stenosis / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000628:therapy; D016275:Atrial Function; D002404:Catheterization; D003971:Diastole / Q000502:physiology*; D018619:Echocardiography, Doppler, Pulsed; D004695:Endocardial Fibroelastosis / Q000150:complications / Q000503:physiopathology; D017809:Fatal Outcome; D006439:Hemodynamics; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D012039:Regional Blood Flow