title: A novel method to estimate pulmonary artery wedge pressure using the downslope of the Doppler mitral regurgitant velocity profile.
abstract: Continuous-wave (CW) Doppler recording of mitral regurgitation (MR) is a reflection of the left ventriculoatrial pressure gradient. Accordingly, this jet may yield information about pulmonary artery wedge pressure (PAWP). In this study, we derived and then evaluated a novel method for prediction of PAWP. Patients (n=80) with moderate to severe MR and left ventricular dysfunction were included in the study. Transthoracic echocardiography was performed in patients during pulmonary artery pressure monitoring. A satisfactory CW Doppler recording of MR was obtained in 63/80 (78%). On the late descending portion of the CW recording, the time from a velocity of 4 m/sec to the end of the jet was defined as t1, and from 3 m/sec to the end of the jet as t2. Mathematical derivation of t1/t2 as a predictor of PAWP, was performed based on Weiss' derivation. If t1/t2 was <1.30, the PAWP was normal. If t1/t2 > 1.44, the PAWP was > 16 mmHg. With this new mathematical derivation, it appears that the downslope of the CW Doppler MR waveform may be able to distinguish a normal from elevated PAWP.
authors.affiliation: Gulhane Military Medical Academy, Department of Cardiology, Ankara, Turkey. mhemetxuzun@yahoo.com
authors.forename: Mehmet
authors.initials: M
authors.lastname: Uzun
authors.forename: Kursad
authors.initials: K
authors.lastname: Erinc
authors.forename: Ata
authors.initials: A
authors.lastname: Kirilmaz
authors.forename: Oben
authors.initials: O
authors.lastname: Baysan
authors.forename: Cemal
authors.initials: C
authors.lastname: Sag
authors.forename: Fethi
authors.initials: F
authors.lastname: Kilicarslan
authors.forename: Celal
authors.initials: C
authors.lastname: Genc
authors.forename: Hayrettin
authors.initials: H
authors.lastname: Karaeren
authors.forename: Ertan
authors.initials: E
authors.lastname: Demirtas
mesh_terms: D000465:Algorithms; D001783:Blood Flow Velocity; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging* / Q000503:physiopathology; D015588:Observer Variation; D011669:Pulmonary Wedge Pressure / Q000502:physiology*