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J Korean Soc Echocardiogr. 1996 Dec;4(2):174-180. Korean. Original Article. https://doi.org/10.4250/jkse.1996.4.2.174
Park JS , Shin DG , Kim YJ , Shim BS .
Department of Internal Medicine, College of Medicine, Yeung-Nam University, Taegu, Korea.
Abstract

Background

Doppler echocardiography is widely used for the noninvasive evaluation of left ventricular diastolic function. More recently, it has attempted to indirectly assess left hemodynamic status by using different measurements obtained from puled wave Doppler ultrasound mitral flow recordings. However, the mitral flow velocity pattern is affected by several physiologic factors and change to normalized or restricutve pattern, Thus, this study designed to assess the relatioship between intraventricular dispersion of early diastolic flow velocity and hemodynamic variables.

Method

The study population consisted of 8 patients with atypical chest pain, 8 patients with stable angina pectoris, 10 patients with myocardial infarction and 4 patients with dilated cardiomyopathy. Left ventricular catheterization was performed with fluid-filled catheter and left ventricular systolic pressure(LVSP), left ventricular end diastolic pressure(LVEL), -peak/dP/dt, and +peak dP/dt were measured, the mitral flow velocity was recorded at mitral valve tip and regional left ventricular diastolic flow velocity was recored at 1cm, 2cm and 3cm from mitral valve tip to the apex. Regional left ventricular early diastolic flow velocity was expressed as percentage to the early diastolic flow velocity in mitral valve tip(%Ex=(peak Ex/peak E)×100, %VTIEx=VTIEx/VTIE)×100, x=cm from mitral valve tip).

Results

There were modest negative correlations between %E2, %E3 and left ventricular end-diastolic pressure, respectively ; r=−0.62, −0.46. Modest negative correlation was found between %VTIE2 and LVEDP(r=0.42). %E2 < 70 predicted left ventricular end-diastolic pressure>15mmHg with a sensitivity of 74% and specificity of 77%.

Conclusion

Propagation of left ventricular filling flow veolcity in early diastole is correlate with left ventricular end-diastolic pressure and %E2 is a relatively useful index of elevated left ventricular end-diastolic pressure.

Copyright © 2019. Korean Association of Medical Journal Editors.