J Korean Soc Echocardiogr.  1995 Dec;3(2):144-150. 10.4250/jkse.1995.3.2.144.

Patterns of Pulmonary Venous Flow in the Patients with Mitral Stenosis using Transesophageal Echocardiography

• Lee SE
• Lee HJ
• Kang HS
• Choue CW
• Kim KS
• Kim MS
• Song JS
• Bae JH

• KMID: 2410416
• DOI: http://doi.org/10.4250/jkse.1995.3.2.144

Abstract

OBJECTIVES
In mitral stenosis, there is an alteration of normal left atrial hemodynamics because the narrowed mitral valve prolongs the decay in diastolic pressure, and atrial function may be impaired secondary to atrial fibrillation. In this study, we purposed to evaluation of the pulmonary venous flow patterns in the patients with mitral stenosis using transesophageal echocardiography.
METHODS
The study was performed on 35 patients(13 men and 22 women, mean age 51±13.1 years) with mitral stenosis. We measured the left ventricular end-diastolic and end-systolic dimension, left atrial dimension, mitral valve area by planimetry method and the mean pressure gradient by transthoracic echocardiography. Systolic and diastolic peak velocities, atrial reversal and diastolic pressure half time of pulmonary venous flow by transesophageal echocardiography were evaluated.
RESULTS
1) The pulmonary venous peak systolic and diastolic flow velocities were 27.5±7.0cm/sec, 28.2±9.3cm/sec in patients with sinus rhythm, and 23.9±7.6cm/sec, 27.1±8.3cm/sec in patients with artial fibrillation. But there was no difference between patients with sinus rhythm and with atrial fibrillation. 2) The lesser mitral valve area, the more decreased peak systolic velocity and systolic to diastolic flow ratio. Especially, the systolic to diastolic flow ratio was significantly decreased(1.16±0.26, 0.95±0.23, 0.68±0.20, p < 0.05). But there was no difference at the peak diastolic velocity. 3) The thrombus or spontaneous echo contrast in the left atrium was not influence on the pulmonary venous flow pattern.
CONCLUSION
In mitral stenosis, systolic flow and systolic to diastolic flow ratio decrease with the decrease of mitral valve area and diastolic flow becomes predominant, which may be useful in assessing the hemodynamics of mitral stenosis.

Keyword

Pulmonary venous flow; Mitral stenosis

MeSH Terms

Atrial Fibrillation
Atrial Function
Blood Pressure
Echocardiography
Echocardiography, Transesophageal*
Female
Heart Atria
Hemodynamics
Humans
Male
Methods
Mitral Valve
Mitral Valve Stenosis*
Thrombosis

Figure

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  Fig. 1. Patterns of transesophageal echocardiographic pulmonary venous flow in the patients of mitral stenosis with sinus rhythm(upper pannel) and atrial fibrillation (lower pannel). S: systolic, D: diastolic, AR: atrial reversal.

Reference

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