DOPPLER-ECHOCARDIOGRAPHIC PULMONARY VENOUS FLOW VELOCITY PATTERN FOR ASSESSMENT OF THE HEMODYNAMIC PROFILE IN ACUTE CONGESTIVE-HEART-FAILURE

The hemodynamic profile of congestive heart failure (CHF) is best desc ribed in terms of its two primary sets of hemodynamic parameters, that is, left atrial pressure and cardiac output, each of which has a spec ific and independently variable hemodynamic cause. To assess whether a nalysis of the mitral and/or pulmonary venous flow-velocity patterns p rovides valuable information in the noninvasive assessment of the hemo dynamic profile of CHF, these patterns were obtained by using the tran sthoracic approach in 18 patients with acute CHF with simultaneous mea surements of catheter-derived mean pulmonary capillary wedge pressure and thermodilution cardiac index. Measurements were repeated on two oc casions in each case: at the acute stage of CHF and 1 to 5 days after treatment. Peak diastolic pulmonary venous forward flow velocity was h igher, the ratio of pulmonary venous systolic to diastolic peak forwar d flow velocity was lower, and the ratio of mitral early diastolic to late diastolic flow velocity was greater in patients with higher mean pulmonary capillary wedge pressure (r = 0.80, n = 36, p < 0.01; r = -0 .69, n = 36, p < 0.01; r = 0.71, n = 36, p < 0.01). Peak systolic pulm onary venous forward flow velocity and time-velocity integral of the s ystolic pulmonary venous flow wave were greater in patients with large r cardiac index (r = 0.80, n = 36, p < 0.01; r = 0.62, n = 36, p < 0.0 1). In conclusion, two primary sets of hemodynamic parameters, that is , left atrial pressure and cardiac output, can be estimated with Doppl er pulmonary venous flow parameters in patients with acute CHF.