A Novel Method to Estimate Pulmonary Artery Wedge Pressure Using the Downslope of the Doppler Mitral Regurgitant Velocity Profile

• Published in: Echocardiography (Mount Kisco, N.Y.) N.Y.), 2004-11, Vol.21 (8), p.673-679
• Main Authors: Uzun, Mehmet, Erinc, Kursad, Kirilmaz, Ata, Baysan, Oben, Sag, Cemal, Kilicarslan, Fethi, Genc, Celal, Karaeren, Hayrettin, Demirtas, Ertan
• Format: Article
• Language: English
• Subjects: Algorithms; Blood Flow Velocity; Echocardiography, Doppler - methods; Female; Humans; Linear Models; Male; Middle Aged; mitral regurgitation; Mitral Valve Insufficiency - diagnostic imaging; Mitral Valve Insufficiency - physiopathology; Observer Variation; pulmonary artery wedge pressure; Pulmonary Wedge Pressure - physiology
• ISSN: 0742-2822; 1540-8175
• DOI: 10.1111/j.0742-2822.2004.03174.x

Continuous‐wave (CW) Doppler recording of mitral regurgitation (MR) is a reflection of the left ventriculoatrial pressure gradient. Accordingly, this jet may yield information about pulmonary artery wedge pressure (PAWP). In this study, we derived and then evaluated a novel method for prediction of PAWP. Patients (n = 80) with moderate to severe MR and left ventricular dysfunction were included in the study. Transthoracic echocardiography was performed in patients during pulmonary artery pressure monitoring. A satisfactory CW Doppler recording of MR was obtained in 63/80 (78%). On the late descending portion of the CW recording, the time from a velocity of 4 m/sec to the end of the jet was defined as t1, and from 3 m/sec to the end of the jet as t2. Mathematical derivation of t1/t2 as a predictor of PAWP, was performed based on Weiss' derivation. If t1/t2 was 1.44, the PAWP was > 16 mmHg. With this new mathematical derivation, it appears that the downslope of the CW Doppler MR waveform may be able to distinguish a normal from elevated PAWP.