title: Preload-dependent variation of the propagation velocity in patients with congestive heart failure.
abstract: BACKGROUND
  Although color Doppler M-mode propagation velocity (Vp) is preload-independent, the variation in Vp with the temporal variation of preload in the clinical setting has not been evaluated. Because left ventricular filling pressure changes dramatically with treatment of congestive heart failure (CHF), we hypothesized that preload-dependent variations in Vp occur with treatment of CHF.
  
  
  METHODS
  We performed Doppler echocardiographic and hemodynamic evaluation in 24 patients with CHF (15 men, 62 +/- 10 years) at initial presentation (baseline study) and after CHF had improved with therapy (second study).
  
  
  RESULTS
  The interval between the baseline and the second study was 48.6 +/- 21.5 hours. Vp decreased between the baseline study (41 +/- 5 cm/s) and the second study (28 +/- 5 cm/s, P <.0001). Only the change in pulmonary capillary wedge pressure (-8.3 +/- 3.3 mm Hg) between the baseline and second study was an independent predictor of the change in Vp (-12.5 +/- 5.9 cm/s) by stepwise linear regression (r = 0.68, P =.0002).
  
  
  CONCLUSIONS
  Vp decreases significantly with decreases in pulmonary capillary wedge pressure with the treatment of CHF. The preload-dependent variation should be taken into account in the assessment of Vp in patients with CHF.
authors.affiliation: Department of Internal Medicine, Ibaraki Seinan Medical Center Hospital, Sakai, Ibaraki, Japan. seo@bf6.so-net.ne.jp
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Seo
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Ishimitsu
authors.forename: Tomoko
authors.initials: T
authors.lastname: Ishizu
authors.forename: Kenichi
authors.initials: K
authors.lastname: Obara
authors.forename: Naoko
authors.initials: N
authors.lastname: Moriyama
authors.forename: Michiko
authors.initials: M
authors.lastname: Sakane
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Maeda
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Watanabe
authors.forename: Iwao
authors.initials: I
authors.lastname: Yamaguchi
mesh_terms: D000368:Aged; D001783:Blood Flow Velocity; D018618:Echocardiography, Doppler, Color; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged