END-DIASTOLIC PULMONARY VENOUS FLOW AS AN INDICATOR OF LEFT-VENTRICULAR DIASTOLIC PRESSURES

The aim of this study was to analyse the possible relationship between inversion of the end diastolic wave of pulmonary Venous flow (Avp) re corded by transoesophageal echocardiography in the left superior pulmo nary vein and left ventricular end-diastolic pressures (LVEDP) at card iac catheterisation. In this series of patients, there was a poor corr elation between the E/A ratio of transmitral blood flow and LVEDP. On the other hand, there was a better correlation between LVEDP and the d ifference of duration of the end diastolic Avp wave and the A wave of mitral flow. An even better correlation was found between LVEDP with r espect to the contribution of atrial systole and the difference of dur ation Avp-A. When the pressure due to atrial contraction exceeds 15 mm Hg, the difference between the durations of pulmonary and mitral A wav es increases. Therefore, when the duration of the end diastolic Avp is greater than that of the mitral A wave, a LVEDP of over 15 mmHg may b e predicted with a sensitivity of 88 % and a specificity of 74 %.