title: Relationship of echocardiographic indices to pulmonary capillary wedge pressures in healthy volunteers.
abstract: OBJECTIVE
  We sought to determine the relationship between different echocardiographic indices and pulmonary capillary wedge pressures (PCWP) in normal volunteers.
  
  
  BACKGROUND
  Indices based on tissue Doppler (TDE) and color M-mode (CMM) echocardiography have been proposed to reflect left (LV) ventricular filling pressures. These include the ratio of early diastolic transmitral velocity (E) to early myocardial velocity measured by TDE (E') and the ratio of E to the wave propagation velocity (Vp) measured from CMM images. These indices, however, have not been validated in normal individuals.
  
  
  METHODS
  We studied seven volunteers during two phases of preload altering maneuvers, baseline, with two stages of lower body negative pressure, and repeat baseline with two stages of volume loading. The PCWP obtained from right heart catheterization was compared with diastolic indices using pulsed Doppler, TDE and CMM echocardiography.
  
  
  RESULTS
  The PCWP ranged from 2.2 to 23.5 mm Hg. During preload alterations, significant changes in E and septal E' (both p < 0.05) but not lateral E' or Vp were observed. Furthermore, E, septal E' and E/Vp correlated with PCWP (all r > 0.80) but not combined E and TDE indices (both r < 0.15). Within individuals, a similar linear relationship was observed among E/Vp, E and septal E' (average r > 0.80).
  
  
  CONCLUSIONS
  In subjects without heart disease, E, septal E' and E/Vp correlate with PCWP. Because the influence of ventricular relaxation is minimized, the ratio E/Vp may be the best overall index of LV filling pressures.
authors.affiliation: Cardiovascular Imaging Center, Department of Cardiology, The Cleveland Clinic Foundation, Ohio 44195, USA.
authors.forename: M S
authors.initials: MS
authors.lastname: Firstenberg
authors.forename: B D
authors.initials: BD
authors.lastname: Levine
authors.forename: M J
authors.initials: MJ
authors.lastname: Garcia
authors.forename: N L
authors.initials: NL
authors.lastname: Greenberg
authors.forename: L
authors.initials: L
authors.lastname: Cardon
authors.forename: A J
authors.initials: AJ
authors.lastname: Morehead
authors.forename: J
authors.initials: J
authors.lastname: Zuckerman
authors.forename: J D
authors.initials: JD
authors.lastname: Thomas
mesh_terms: D000328:Adult; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D011669:Pulmonary Wedge Pressure / Q000502:physiology*; D012016:Reference Values