title: Left Ventricular Ejection Time Derived From the Common Carotid Artery Doppler Waveform: Association With Left Ventricular Ejection Fraction and Prediction of Heart Failure.
abstract: OBJECTIVE
  Left ventricular ejection time (LVET) is measured from blood pressure tracings as the interval from end diastole to the dicrotic notch and shows associations with left ventricular ejection fraction (LVEF) and heart failure. LVET can be measured on common carotid artery Doppler waveforms. We therefore studied the possible associations of common carotid artery LVET with LVEF measured by echocardiography and heart failure.
  
  
  METHODS
  We performed a retrospective study of 110 patients who had transthoracic echocardiography and carotid Doppler evaluations within 1 day of each other. LVEF was determined by the biplane modified Simpson method. LVET was measured from left common carotid artery Doppler tracings. Linear regression was used to evaluate associations between LVET and LVEF. We also used logistic regression with LVEF of less than 40% as a cut point for heart failure to generate a receiver operating characteristic curve, estimate the area under the curve, and calculate sensitivity and specificity.
  
  
  RESULTS
  LVET was associated with LVEF (P < .0001). The area under the curve of LVET for heart failure was 0.81 (95% confidence interval [CI], 0.72-0.87), and the sensitivity and specificity were 76.9% (95% CI, 65.4%-88.4%) and 65.5% (95% CI, 53.4%-77.8%), respectively, for LVET of 321 milliseconds.
  
  
  CONCLUSIONS
  LVET measured on common carotid artery Doppler tracings decreases with LVEF and is strongly associated with prevalent heart failure. Based on what is known of blood pressure-measured LVET, common carotid artery Doppler waveform-derived LVET could be used to serially monitor cardiac function.
authors.affiliation: Departments of Radiology (J.F.P.) and Vascular Surgery (J.M.A.-C., J.M.E.) and Division of Cardiology, Cardiovascular Center (J.M.A.-C., A.R.P.), Tufts Medical Center, Boston, Massachusetts USA. jpolak@tuftsmedicalcenter.org.
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Polak
authors.affiliation: Departments of Radiology (J.F.P.) and Vascular Surgery (J.M.A.-C., J.M.E.) and Division of Cardiology, Cardiovascular Center (J.M.A.-C., A.R.P.), Tufts Medical Center, Boston, Massachusetts USA.
authors.forename: Jean M
authors.initials: JM
authors.lastname: Alessi-Chinetti
authors.affiliation: Departments of Radiology (J.F.P.) and Vascular Surgery (J.M.A.-C., J.M.E.) and Division of Cardiology, Cardiovascular Center (J.M.A.-C., A.R.P.), Tufts Medical Center, Boston, Massachusetts USA.
authors.forename: James M
authors.initials: JM
authors.lastname: Estes
authors.affiliation: Departments of Radiology (J.F.P.) and Vascular Surgery (J.M.A.-C., J.M.E.) and Division of Cardiology, Cardiovascular Center (J.M.A.-C., A.R.P.), Tufts Medical Center, Boston, Massachusetts USA.
authors.forename: Ayan R
authors.initials: AR
authors.lastname: Patel
mesh_terms: D000368:Aged; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging*; D015150:Echocardiography, Doppler; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000503:physiopathology*
keywords: Doppler sonography; Doppler waveform analysis; carotid artery; echocardiography; ejection fraction; systolic time interval; vascular ultrasound