Influence of normalization techniques upon two-dimensional Doppler-derived peak filling rate: Comparison with radionuclide angiography

In this study we evaluated if two-dimensional Doppler (2DD)-derived peak filling rate (PFR) normalized to stroke volume (SV) could provide a useful index of diastolic function that can be compared to PFR obtained with radionuclide angiography (RNA). Forty-five patients, 22 with clinical evidence of healed myocardial infarction (MI) and 23 of primary hypertension underwent 2DD and RNA study within 24 h. 2DD- and RNA-derived PFR were normalized to end-diastolic volume (PFR-EDV) and to SV (PFR-SV): PFR determined by 2DD correlated with RNA in the total study population (r = 0.45; p <0.01), in MI (r = 0.51; p <0.01) and in hypertensive (H) patients (r = 0.43; p <0.05) when both were normalized to SV; however, when normalized to end-diastolic volume, 2DD-derived PFR also correlated with RNA in the total study population (r = 0.36; p <0.05) and in H patients (r = 0.48; p <0.05) but not in MI patients (r = 0.37; NS). Furthermore, PFR-SV and PFR-EDV measured by RNA closely correlated in the total study population (r = 0.81; p <0.001), in MI (r = 0.86; p <0.001), and in H patients (r = 0.86; p <0.001), while, when assessed by 2DD, the r values of the correlations between the same parameters in the total study population (r = 0.44; p <0.01), in MI (r = 0.47; p <0.05) and in H patients (r = 0.43; p <0.05) were lower. Thus, 2DD-derived PFR normalized to SV more than to EDV might be useful in assessing left ventricular diastolic filling abnormalities in cardiac patients, in particular in those with healed MI.