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Clinical utility of Doppler echocardiography and tissue Doppler imaging in the estimation of left ventricular filling pressures : A comparative simultaneous Doppler-catheterization study
Noninvasive assessment of diastolic filling by Doppler echocardiography provides important information about left ventricular (LV) status in selected subsets of patients. This study was designed to assess whether mitral annular velocities as assessed by tissue Doppler imaging are associated with inv...
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Published in: | Circulation (New York, N.Y.) N.Y.), 2000-10, Vol.102 (15), p.1788-1794 |
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creator | OMMEN, S. R NISHIMURA, R. A APPLETON, C. P MILLER, F. A OH, J. K REDFIELD, M. M TAJIK, A. J |
description | Noninvasive assessment of diastolic filling by Doppler echocardiography provides important information about left ventricular (LV) status in selected subsets of patients. This study was designed to assess whether mitral annular velocities as assessed by tissue Doppler imaging are associated with invasive measures of diastolic LV performance and whether additional information is gained over traditional Doppler variables.
One hundred consecutive patients referred for cardiac catheterization underwent simultaneous Doppler interrogation. Invasive measurements of LV pressures were obtained with micromanometer-tipped catheters, and the mean LV diastolic pressure (M-LVDP) was used as a surrogate for mean left atrial pressure. Doppler signals from the mitral inflow, pulmonary venous inflow, and TDI of the mitral annulus were obtained. Isolated parameters of transmitral flow correlated with M-LVDP only when ejection fraction |
doi_str_mv | 10.1161/01.CIR.102.15.1788 |
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One hundred consecutive patients referred for cardiac catheterization underwent simultaneous Doppler interrogation. Invasive measurements of LV pressures were obtained with micromanometer-tipped catheters, and the mean LV diastolic pressure (M-LVDP) was used as a surrogate for mean left atrial pressure. Doppler signals from the mitral inflow, pulmonary venous inflow, and TDI of the mitral annulus were obtained. Isolated parameters of transmitral flow correlated with M-LVDP only when ejection fraction <50%. The ratio of mitral velocity to early diastolic velocity of the mitral annulus (E/E') showed a better correlation with M-LVDP than did other Doppler variables for all levels of systolic function. E/E' <8 accurately predicted normal M-LVDP, and E/E' >15 identified increased M-LVDP. Wide variability was present in those with E/E' of 8 to 15. A subset of those patients with E/E' 8 to 15 could be further defined by use of other Doppler data.
The combination of tissue Doppler imaging of the mitral annulus and mitral inflow velocity curves provides better estimates of LV filling pressures than other methods (pulmonary vein, preload reduction). However, accurate prediction of filling pressures for an individual patient requires a stepwise approach incorporating all available data.</description><identifier>ISSN: 0009-7322</identifier><identifier>EISSN: 1524-4539</identifier><identifier>DOI: 10.1161/01.CIR.102.15.1788</identifier><identifier>PMID: 11023933</identifier><identifier>CODEN: CIRCAZ</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Aged ; Biological and medical sciences ; Cardiovascular system ; Diastole ; Echocardiography, Doppler - methods ; Female ; Heart - physiology ; Humans ; Investigative techniques, diagnostic techniques (general aspects) ; Male ; Medical sciences ; Middle Aged ; Ultrasonic investigative techniques ; Ventricular Function ; Ventricular Function, Left</subject><ispartof>Circulation (New York, N.Y.), 2000-10, Vol.102 (15), p.1788-1794</ispartof><rights>2000 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c371t-fcbf3e70c4dde9c0d156d113737e170b110e412426036076c45c7ba78d888cb43</citedby><cites>FETCH-LOGICAL-c371t-fcbf3e70c4dde9c0d156d113737e170b110e412426036076c45c7ba78d888cb43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1523631$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11023933$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>OMMEN, S. R</creatorcontrib><creatorcontrib>NISHIMURA, R. A</creatorcontrib><creatorcontrib>APPLETON, C. P</creatorcontrib><creatorcontrib>MILLER, F. A</creatorcontrib><creatorcontrib>OH, J. K</creatorcontrib><creatorcontrib>REDFIELD, M. M</creatorcontrib><creatorcontrib>TAJIK, A. J</creatorcontrib><title>Clinical utility of Doppler echocardiography and tissue Doppler imaging in the estimation of left ventricular filling pressures : A comparative simultaneous Doppler-catheterization study</title><title>Circulation (New York, N.Y.)</title><addtitle>Circulation</addtitle><description>Noninvasive assessment of diastolic filling by Doppler echocardiography provides important information about left ventricular (LV) status in selected subsets of patients. This study was designed to assess whether mitral annular velocities as assessed by tissue Doppler imaging are associated with invasive measures of diastolic LV performance and whether additional information is gained over traditional Doppler variables.
One hundred consecutive patients referred for cardiac catheterization underwent simultaneous Doppler interrogation. Invasive measurements of LV pressures were obtained with micromanometer-tipped catheters, and the mean LV diastolic pressure (M-LVDP) was used as a surrogate for mean left atrial pressure. Doppler signals from the mitral inflow, pulmonary venous inflow, and TDI of the mitral annulus were obtained. Isolated parameters of transmitral flow correlated with M-LVDP only when ejection fraction <50%. The ratio of mitral velocity to early diastolic velocity of the mitral annulus (E/E') showed a better correlation with M-LVDP than did other Doppler variables for all levels of systolic function. E/E' <8 accurately predicted normal M-LVDP, and E/E' >15 identified increased M-LVDP. Wide variability was present in those with E/E' of 8 to 15. A subset of those patients with E/E' 8 to 15 could be further defined by use of other Doppler data.
The combination of tissue Doppler imaging of the mitral annulus and mitral inflow velocity curves provides better estimates of LV filling pressures than other methods (pulmonary vein, preload reduction). 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A</creatorcontrib><creatorcontrib>APPLETON, C. P</creatorcontrib><creatorcontrib>MILLER, F. A</creatorcontrib><creatorcontrib>OH, J. K</creatorcontrib><creatorcontrib>REDFIELD, M. M</creatorcontrib><creatorcontrib>TAJIK, A. J</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation (New York, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>OMMEN, S. R</au><au>NISHIMURA, R. A</au><au>APPLETON, C. P</au><au>MILLER, F. A</au><au>OH, J. K</au><au>REDFIELD, M. M</au><au>TAJIK, A. J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical utility of Doppler echocardiography and tissue Doppler imaging in the estimation of left ventricular filling pressures : A comparative simultaneous Doppler-catheterization study</atitle><jtitle>Circulation (New York, N.Y.)</jtitle><addtitle>Circulation</addtitle><date>2000-10-10</date><risdate>2000</risdate><volume>102</volume><issue>15</issue><spage>1788</spage><epage>1794</epage><pages>1788-1794</pages><issn>0009-7322</issn><eissn>1524-4539</eissn><coden>CIRCAZ</coden><abstract>Noninvasive assessment of diastolic filling by Doppler echocardiography provides important information about left ventricular (LV) status in selected subsets of patients. This study was designed to assess whether mitral annular velocities as assessed by tissue Doppler imaging are associated with invasive measures of diastolic LV performance and whether additional information is gained over traditional Doppler variables.
One hundred consecutive patients referred for cardiac catheterization underwent simultaneous Doppler interrogation. Invasive measurements of LV pressures were obtained with micromanometer-tipped catheters, and the mean LV diastolic pressure (M-LVDP) was used as a surrogate for mean left atrial pressure. Doppler signals from the mitral inflow, pulmonary venous inflow, and TDI of the mitral annulus were obtained. Isolated parameters of transmitral flow correlated with M-LVDP only when ejection fraction <50%. The ratio of mitral velocity to early diastolic velocity of the mitral annulus (E/E') showed a better correlation with M-LVDP than did other Doppler variables for all levels of systolic function. E/E' <8 accurately predicted normal M-LVDP, and E/E' >15 identified increased M-LVDP. Wide variability was present in those with E/E' of 8 to 15. A subset of those patients with E/E' 8 to 15 could be further defined by use of other Doppler data.
The combination of tissue Doppler imaging of the mitral annulus and mitral inflow velocity curves provides better estimates of LV filling pressures than other methods (pulmonary vein, preload reduction). However, accurate prediction of filling pressures for an individual patient requires a stepwise approach incorporating all available data.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>11023933</pmid><doi>10.1161/01.CIR.102.15.1788</doi><tpages>7</tpages></addata></record> |
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subjects | Aged Biological and medical sciences Cardiovascular system Diastole Echocardiography, Doppler - methods Female Heart - physiology Humans Investigative techniques, diagnostic techniques (general aspects) Male Medical sciences Middle Aged Ultrasonic investigative techniques Ventricular Function Ventricular Function, Left |
title | Clinical utility of Doppler echocardiography and tissue Doppler imaging in the estimation of left ventricular filling pressures : A comparative simultaneous Doppler-catheterization study |
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