Intraventricular pressure gradients in left ventricular aneurysms determined by color M-mode Doppler method: an animal study.
BACKGROUND
Left ventricular aneurysm (LVA) may affect diastolic intraventricular blood flow. Color M-mode (CMM) Doppler flow propagation patterns are abnormal in the presence of apical aneurysms. The aim of this study was to validate the accuracy of CMM echocardiography for assessing the existence and size of LVA and to determine the intraventricular pressure gradient in LVA.


METHODS
CMM of the transmitral inflow in early diastole was obtained from the apical 4-chamber view in 19 sheep. The presence of the break point where the velocity decreased abruptly in the mitral inflow (point D) was determined and the distance between the apex and point D was measured. The intraventricular pressure difference between the base and the apex was measured by a catheter while it was calculated using CMM with the Euler equation.


RESULTS
The presence of the break point D showed 84% sensitivity and 100% specificity for determining the existence of an LVA. Distance between the apex and point D correlated well with scar size. Catheter- and CMM-derived intraventricular pressure difference correlated and agreed well (y = 1.0 x -0.2, r = 0.94).


CONCLUSIONS
The point of abrupt decrease in propagation velocity of the CMM recording indicated the presence and size of LVA. Intraventricular pressure gradients were determined noninvasively by CMM echocardiography with reasonable accuracy.
Asada-Kamiguchi
Junko
J
Department of Cardiovascular Medicine, The Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
Jones
Michael
M
Greenberg
Neil L
NL
Popovic
Zoran B
ZB
Tsujino
Hiroyuki
H
Zetts
Arthur D
AD
Qin
Jian Xin
JX
Garcia
Mario J
MJ
Thomas
James D
JD
Shiota
Takahiro
T
D000818:Animals; D001783:Blood Flow Velocity; D001794:Blood Pressure; D018618:Echocardiography, Doppler, Color / Q000379:methods*; D006322:Heart Aneurysm / Q000150:complications / Q000000981:diagnostic imaging*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012756:Sheep; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology