Echocardiographic evaluation of left ventricular diastolic function: correlation between echocardiographic and hemodynamic parameters.
OBJECTIVE
The aim of this study was to assess the correlation between non invasive echo-Doppler parameters of diastolic function and invasively measured end-diastolic left ventricular (LV) filling pressures in patients with normal or depressed LV function.


METHODS
The patient population was composed of 44 subjects, (34 men and 10 women) 52% with normal ventricular function, who underwent echo-Doppler and hemodynamic evaluation within 24 hours between the two exams.


RESULTS
LV end-diastolic pressure was statistically different (P=0.022) in the 4 subgroups divided on the basis of the mitral flow pattern in the overall population and in the patients with depressed LV function, but not in those with normal LV function. In the overall population LV end-diastolic pressure was significantly correlated with: 1) E/A ratio of mitral flow (r=0.45, P=0.002); 2) mitral E wave peak velocity (r=0.39, P=0.017); 3) isovolumic relaxation time (r=-0.34, P=0.01); 4) left atrial diameter (r=0.33, P=0.037); 5) duration of retrograde A wave of pulmonary venous flow (r=0.33, P=0.03); 6) Pulmonary vein D wave peak velocity (r=0.29, P=0,05). Multivariate analysis showed that the correlation between the echo-Doppler variables and LV end-diastolic pressure was statistically significant only in patients with depressed LV function, but not in those with normal function.


CONCLUSIONS
Among the echo-Doppler variables examined, those derived from transmitral flow and pulmonary vein flow show the best correlation with left ventricular end-diastolic pressure; however, the correlation is statistically significant only in patients with depressed LV function. Thus, the echo-Doppler evaluation of LV diastolic function should take into account this limitation and should be based on a multiparametric approach.
Previtali
M
M
Department of Cardiology, IRCCS Policlinico S. Matteo, University of Pavia, Pavia, Italy. m.previtali@smatteo.pv.it
Chieffo
E
E
Ferrario
M
M
Klersy
C
C
D000704:Analysis of Variance; D003627:Data Interpretation, Statistical; D003971:Diastole; D015150:Echocardiography, Doppler; D006439:Hemodynamics; D006801:Humans; D015999:Multivariate Analysis; D018579:Patient Selection; D016276:Ventricular Function