Doppler-derived mitral deceleration time of early filling as a strong predictor of pulmonary capillary wedge pressure in postinfarction patients with left ventricular systolic dysfunction

Pantaleo Giannuzzi, Alessandro Imparato, Pier L. Temporelli, Francesco de Vito, Pedro L. Silva, Francesco Scapellato, Amerigo Giordano

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Abstract

Objectives. The aim of this study was to investigate the correlations between Doppler-derlved transmitral flow velocity variables and pulmonary capillary wedge pressure in patients with severe left ventricular systolic dysfunction. Background. Abnormal relaxation and increased chamber stiffness have opposing effects on the left ventricular filling pattern. When both abnormalities are present at the same time, as often occurs in patients with systolic dysfunction, the ability of Doppler recording to assess diastolic function and predict left ventricular fillng pressure may be significantly compromised. Method. Pulmonary capillary wedge pressure and Doppler transmitral flow velocity profile were simultaneously recorded in 140 postinfarction patients with ejection fraction ≤35%. Results. Correlation between the ratio of mitral peak low velocity in early diastole to peak low velocity in late diastole ( E A ratio) and pulmonary capillary wedge pressure was weak (r = 0.65). Although the specificity of E A ≥ 2 in predicting ≥29 mm Hg in pulmonary capillary wedge pressure was high (99%), its sensitivity was low (43%). Conversely, a very close negative correlation was found between mitral deceleration time of early filling and pulmonary capillary wedge pressure (r = -0.91). Sensitivity and specificity of ≤120 ms in deceleration time in predicting ≥20 mm Hg in pulmonary capillary wedge pressure were 100% and 99%, respectively. Conclusions. Doppler-derived mitral deceleration time of early filling provides a simple and accurate means of estimating pulmonary capillary wedge pressure that is particularly useful in patients with a normal or normalized mitral low velocity pattern.

Original languageEnglish
Pages (from-to)1630-1637
Number of pages8
JournalJournal of the American College of Cardiology
Volume23
Issue number7
DOIs
Publication statusPublished - 1994

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Pulmonary Wedge Pressure
Deceleration
Left Ventricular Dysfunction
Diastole
Ventricular Pressure
varespladib methyl
Sensitivity and Specificity

ASJC Scopus subject areas

  • Nursing(all)

Cite this

@article{5999d1a1edae4bbe9774e092cebae448,
title = "Doppler-derived mitral deceleration time of early filling as a strong predictor of pulmonary capillary wedge pressure in postinfarction patients with left ventricular systolic dysfunction",
abstract = "Objectives. The aim of this study was to investigate the correlations between Doppler-derlved transmitral flow velocity variables and pulmonary capillary wedge pressure in patients with severe left ventricular systolic dysfunction. Background. Abnormal relaxation and increased chamber stiffness have opposing effects on the left ventricular filling pattern. When both abnormalities are present at the same time, as often occurs in patients with systolic dysfunction, the ability of Doppler recording to assess diastolic function and predict left ventricular fillng pressure may be significantly compromised. Method. Pulmonary capillary wedge pressure and Doppler transmitral flow velocity profile were simultaneously recorded in 140 postinfarction patients with ejection fraction ≤35{\%}. Results. Correlation between the ratio of mitral peak low velocity in early diastole to peak low velocity in late diastole ( E A ratio) and pulmonary capillary wedge pressure was weak (r = 0.65). Although the specificity of E A ≥ 2 in predicting ≥29 mm Hg in pulmonary capillary wedge pressure was high (99{\%}), its sensitivity was low (43{\%}). Conversely, a very close negative correlation was found between mitral deceleration time of early filling and pulmonary capillary wedge pressure (r = -0.91). Sensitivity and specificity of ≤120 ms in deceleration time in predicting ≥20 mm Hg in pulmonary capillary wedge pressure were 100{\%} and 99{\%}, respectively. Conclusions. Doppler-derived mitral deceleration time of early filling provides a simple and accurate means of estimating pulmonary capillary wedge pressure that is particularly useful in patients with a normal or normalized mitral low velocity pattern.",
author = "Pantaleo Giannuzzi and Alessandro Imparato and Temporelli, {Pier L.} and Vito, {Francesco de} and Silva, {Pedro L.} and Francesco Scapellato and Amerigo Giordano",
year = "1994",
doi = "10.1016/0735-1097(94)90667-X",
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T1 - Doppler-derived mitral deceleration time of early filling as a strong predictor of pulmonary capillary wedge pressure in postinfarction patients with left ventricular systolic dysfunction

AU - Giannuzzi, Pantaleo

AU - Imparato, Alessandro

AU - Temporelli, Pier L.

AU - Vito, Francesco de

AU - Silva, Pedro L.

AU - Scapellato, Francesco

AU - Giordano, Amerigo

PY - 1994

Y1 - 1994

N2 - Objectives. The aim of this study was to investigate the correlations between Doppler-derlved transmitral flow velocity variables and pulmonary capillary wedge pressure in patients with severe left ventricular systolic dysfunction. Background. Abnormal relaxation and increased chamber stiffness have opposing effects on the left ventricular filling pattern. When both abnormalities are present at the same time, as often occurs in patients with systolic dysfunction, the ability of Doppler recording to assess diastolic function and predict left ventricular fillng pressure may be significantly compromised. Method. Pulmonary capillary wedge pressure and Doppler transmitral flow velocity profile were simultaneously recorded in 140 postinfarction patients with ejection fraction ≤35%. Results. Correlation between the ratio of mitral peak low velocity in early diastole to peak low velocity in late diastole ( E A ratio) and pulmonary capillary wedge pressure was weak (r = 0.65). Although the specificity of E A ≥ 2 in predicting ≥29 mm Hg in pulmonary capillary wedge pressure was high (99%), its sensitivity was low (43%). Conversely, a very close negative correlation was found between mitral deceleration time of early filling and pulmonary capillary wedge pressure (r = -0.91). Sensitivity and specificity of ≤120 ms in deceleration time in predicting ≥20 mm Hg in pulmonary capillary wedge pressure were 100% and 99%, respectively. Conclusions. Doppler-derived mitral deceleration time of early filling provides a simple and accurate means of estimating pulmonary capillary wedge pressure that is particularly useful in patients with a normal or normalized mitral low velocity pattern.

AB - Objectives. The aim of this study was to investigate the correlations between Doppler-derlved transmitral flow velocity variables and pulmonary capillary wedge pressure in patients with severe left ventricular systolic dysfunction. Background. Abnormal relaxation and increased chamber stiffness have opposing effects on the left ventricular filling pattern. When both abnormalities are present at the same time, as often occurs in patients with systolic dysfunction, the ability of Doppler recording to assess diastolic function and predict left ventricular fillng pressure may be significantly compromised. Method. Pulmonary capillary wedge pressure and Doppler transmitral flow velocity profile were simultaneously recorded in 140 postinfarction patients with ejection fraction ≤35%. Results. Correlation between the ratio of mitral peak low velocity in early diastole to peak low velocity in late diastole ( E A ratio) and pulmonary capillary wedge pressure was weak (r = 0.65). Although the specificity of E A ≥ 2 in predicting ≥29 mm Hg in pulmonary capillary wedge pressure was high (99%), its sensitivity was low (43%). Conversely, a very close negative correlation was found between mitral deceleration time of early filling and pulmonary capillary wedge pressure (r = -0.91). Sensitivity and specificity of ≤120 ms in deceleration time in predicting ≥20 mm Hg in pulmonary capillary wedge pressure were 100% and 99%, respectively. Conclusions. Doppler-derived mitral deceleration time of early filling provides a simple and accurate means of estimating pulmonary capillary wedge pressure that is particularly useful in patients with a normal or normalized mitral low velocity pattern.

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