T. Imanishi et al., IDENTIFICATION OF PSEUDONORMAL TRANSMITRAL FLOW PATTERN USING COLOR DOPPLER-ECHOCARDIOGRAPHY, Japanese Circulation Journal, 60(10), 1996, pp. 749-757
The jet size of flow in color Doppler is dependent on both jet momentu
m and the compliance of the receiving chamber. Thus, the jet size of l
eft ventricular (LV) late filling standardized by its jet momentum sho
uld reflect LV compliance. We investigated the feasibility of using co
lor Doppler echocardiography to differentiate a pseudonormal from a no
rmal transmitral flow pattern. We divided 37 patients with ischemic he
art diseases who demonstrated a ''normal'' transmitral flow pattern in
to 2 groups according to their LV end-diastolic pressure (LVEDP): a ps
eudonormalization group (LVEDP greater than or equal to 18 mmHg, 16 pa
tients), and a normal group (LVEDP<18 mmHg, 21 patients). We measured
the maximum color Doppler jet length (L) and the peak velocity of tran
smitral flow during atrial contraction (Av). Filling volume (Q) was me
asured as the increase in LV volume during atrial contraction. A simpl
ified jet momentum index (M) was obtained from AvxQ, and L/M was consi
dered to reflect LV compliance. L/M was significantly lower in the pse
udonormalization group than in the normal group (1.55+/-0.46x10(-3) vs
2.72+/-0.59x10(-3), p<0.01). On the other hand, conventional Doppler
variables such as isovolumic relaxation time and the deceleration time
of early diastolic filling were not sufficient for discriminating bet
ween the 2 groups. In conclusion, color Doppler echocardiogram during
atrial contraction was useful for differentiating a pseudonormal from
a normal transmitral flow pattern.