Doppler evaluation of systolic and diastolic heart failure in patients with cardiomyopathy.
OBJECTIVE
Analysis of transmitral flow with Doppler echocardiography can currently evaluate left ventricular diastolic function noninvasively and easily. In addition, measurement of pulmonary venous flow and left atrial appendage flow clarifies not only left ventricular diastolic function but also left atrial systolic function in patients with left ventricular systolic failure and diastolic failure.


RESULTS
Doppler echocardiography was used to investigate the differences in left ventricular diastolic dysfunction. In patients with systolic heart failure, left atrial dysfunction due to afterload mismatch to the left ventricle was related to the reduction of transmitral atrial filling wave in a restrictive pattern. In contrast, in patients with diastolic heart failure, transmitral flow seldom indicated a restrictive pattern because left atrial systolic function was preserved even with high pulmonary wedge pressure.


CONCLUSIONS
Left ventricular diastolic dysfunction is somewhat distinct between patients with left ventricular systolic failure and patients with left ventricular diastolic failure. Atrial reversal flow in pulmonary vein has the potential to predict left ventricular filling pressure in patients with diastolic failure.
Suwa
M
M
Third Division, Department of Internal Medicine, Osaka Medical College, Daigaku-cho 2-7, Takatsuki, Osaka 569-8686, Japan.
Ito
T
T
D009202:Cardiomyopathies / Q000000981:diagnostic imaging* / Q000503:physiopathology; D003937:Diagnosis, Differential; D003971:Diastole; D015150:Echocardiography, Doppler; D006333:Heart Failure / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D013599:Systole; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000503:physiopathology; D016277:Ventricular Function, Left