title: Prediction of mean pulmonary wedge pressure using doppler pulmonary venous flow variables in hypertrophic cardiomyopathy.
abstract: We examined whether pulmonary venous flow variables, assessed by transthoracic Doppler echocardiography, could predict mean pulmonary wedge pressure in hypertrophic cardiomyopathy. Forty-four patients with no left ventricular systolic dysfunction (left ventricular fractional shortening > or =25%) were studied. Forty patients with systolic dysfunction (dilated cardiomyopathy group) served as control. Mitral and pulmonary venous flow velocity curves were recorded with the pulsed-Doppler method and were related to mean pulmonary wedge pressure obtained by right heart catheterization. In hypertrophic cardiomyopathy group, the systolic (r=-0.15, P=0.335) and diastolic (r=0.35, P=0.022) forward flow velocity were poorly related to mean pulmonary wedge pressure, whereas the velocity of atrial reversal (r=0.68, P<0.001) correlated well with mean pulmonary wedge pressure. In dilated cardiomyopathy group, the systolic (r=-0.51, P=0.001) and diastolic (r=0.60, P<0.001) forward flow velocity were strongly related to mean pulmonary wedge pressure. With the cut-off value set at the velocity of atrial reversal >30 cm/s in hypertrophic cardiomyopathy group, the sensitivity for predicting mean pulmonary wedge pressure >15 mmHg was 79% and the specificity was 73%. In conclusion, the atrial component of the pulmonary venous flow can be used to predict mean pulmonary wedge pressure in hypertrophic cardiomyopathy.
authors: Osaka University Medical College, The Third Division, Department of Internal Medicine, 2-7 Daigaku-cho, Takatsuki City, 569-8686, Osaka, Japan. in3016@poh.osaka-med.ac.jp
authors: T
authors: T
authors: Ito
authors: M
authors: M
authors: Suwa
authors: A
authors: A
authors: Kobashi
authors: T
authors: T
authors: Nakamura
authors: S
authors: S
authors: Miyazaki
authors: Y
authors: Y
authors: Hirota
mesh_terms: D000328:Adult; D000368:Aged; D001783:Blood Flow Velocity; D006328:Cardiac Catheterization; D002312:Cardiomyopathy, Hypertrophic / Q000000981:diagnostic imaging / Q000503:physiopathology*; D016022:Case-Control Studies; D003971:Diastole / Q000502:physiology; D015150:Echocardiography, Doppler; D005260:Female; D006439:Hemodynamics; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000503:physiopathology; D015588:Observer Variation; D011237:Predictive Value of Tests; D011652:Pulmonary Circulation; D011669:Pulmonary Wedge Pressure; D012680:Sensitivity and Specificity