title: Single-beat differentiation among left ventricular filling patterns by pulsed wave Doppler echocardiography.
abstract: We sought to evaluate whether the combination of phantom E wave peak velocity (Ep) to phantom A wave peak velocity (Ap) ratio at the apex (Ep/Ap) and pulsed wave Doppler left ventricular (LV) inflow propagation velocity (LVIPVpw) or the combination of Ep/Ap and Ep/LVIPVpw obtained from the same heartbeat can effectively differentiate LV filling patterns. The study population included 132 patients. They were classified into normal, abnormal relaxation, and pseudonormal/restrictive groups according to the ratio of early to late transmittal filling wave peak velocity (E/A), color M-mode Doppler LV inflow propagation velocity, and E/color M-mode Doppler LV inflow propagation velocity. Standard Doppler parameters of LV filling such as E, A, E/A, and E-wave deceleration time had a bimodal distribution, but LVIPVpw decreased and Ep/LVIPVpw increased progressively with worsening of LV diastolic function (both P < .001). The sensitivity and specificity of combination of Ep/Ap 1 or greater and LVIPVpw less than 77 cm/s or of Ep/Ap 1 or greater and Ep/LVIPVpw greater than 0.87 from the same heartbeat in identifying the pseudonormal/restrictive LV filling pattern were 81% and 95% or 81% and 93%, respectively. In conclusion, with application of range ambiguity phenomenon, it is simple and feasible to differentiate LV filling patterns on the same cardiac cycle by pulsed wave Doppler echocardiography.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University, Chung-Ho Memorial Hospital, Kaohsiung, Taiwan.
authors.forename: Ho-Ming
authors.initials: HM
authors.lastname: Su
authors.forename: Tsung-Hsien
authors.initials: TH
authors.lastname: Lin
authors.forename: Wen-Chol
authors.initials: WC
authors.lastname: Voon
authors.forename: Kun-Tai
authors.initials: KT
authors.lastname: Lee
authors.forename: Chih-Sheng
authors.initials: CS
authors.lastname: Chu
authors.forename: Hsueh-Wei
authors.initials: HW
authors.lastname: Yen
authors.forename: Wen-Ter
authors.initials: WT
authors.lastname: Lai
authors.forename: Sheng-Hsiung
authors.initials: SH
authors.lastname: Sheu
mesh_terms: D000328:Adult; D001783:Blood Flow Velocity; D018619:Echocardiography, Doppler, Pulsed / Q000379:methods*; D005260:Female; D006339:Heart Rate; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging*