Jm. Lee et al., EFFECTS OF VASODILATORS ON PULMONARY VENOUS AND MITRAL FLOW VELOCITY PATTERNS IN PATIENTS WITH CONGESTIVE-HEART-FAILURE, Japanese Circulation Journal, 57(10), 1993, pp. 935-946
To characterize abnormalities in pulmonary venous flow velocity patter
ns and to explore the changes in these patterns following short-term (
3 to 14 days) administration of vasodilators, pulmonary venous and mit
ral flow velocity patterns were serially studied at congestive heart f
ailure and after vasodilator administration in 18 patients. Peak mitra
l early diastolic filling velocity (E) and the ratio of E to peak fill
ing velocity at atrial contraction (E/A) consistently decreased after
vasodilator administration by 30 +/- 4 cm/s and 0.74 +/- 0.13 (mean +/
- SD), respectively. Peak pulmonary venous diastolic forward flow velo
city also decreased by 29 +/- 4 cm/s. However, changes in peak pulmona
ry venous systolic forward flow velocity (S, cm/s) did not correlate w
ith changes in E, the E/A ratio, or D (peak pulmonary venous diastolic
forward flow velocity). Thus, when patients were divided into two gro
ups on the basis of changes in of left ventricular systolic performanc
e, such as end-systolic dimension and fractional shortening, improved
more in the group which showed an increase in S after vasodilator admi
nistration than in the group which showed a decrease in S (-7 +/- 6 vs
- 1 +/- 4 mm, p<0.05; 8 +/- 6 vs - 1 +/- 4%, p<0.05). Although the mi
tral flow velocity pattern changed uniformly with vasodilator administ
ration in patients with mild to moderate congestive heart failure, the
changes in pulmonary venous flow velocity patterns were not uniform a
mong patients. Pulmonary venous flow velocity patterns appear to refle
ct changes in left ventricular systolic performance in addition to tho
se in left ventricular diastolic performance.