A novel method to estimate pulmonary artery wedge pressure using the downslope of the Doppler mitral regurgitant velocity profile.
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.
Uzun
Mehmet
M
Gulhane Military Medical Academy, Department of Cardiology, Ankara, Turkey. mhemetxuzun@yahoo.com
Erinc
Kursad
K
Kirilmaz
Ata
A
Baysan
Oben
O
Sag
Cemal
C
Kilicarslan
Fethi
F
Genc
Celal
C
Karaeren
Hayrettin
H
Demirtas
Ertan
E
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*