IDENTIFICATION OF PSEUDONORMAL TRANSMITRAL FLOW PATTERN USING COLOR DOPPLER-ECHOCARDIOGRAPHY

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.