THE ASSOCIATION BETWEEN DOPPLER TRANSMITRAL FLOW VARIABLES MEASURED BY TRANSESOPHAGEAL ECHOCARDIOGRAPHY AND PULMONARY CAPILLARY WEDGE PRESSURE

The association between Doppler transmitral flow variables, measured b y transesophageal echocardiography (TEE), and pulmonary capillary wedg e pressure (PCWP) was studied in 88 patients undergoing coronary arter y surgery. The Doppler flow variables and PCWP were measured after ste rnotomy by blinded investigators. In the first part of the study, pati ents were divided into two groups according to left ventricular (LV) e jection fraction (EF): Group A, EF >35% (n = 38) and Group B, EF less than or equal to 35% (n = 34). In Group B, significant correlations we re found between deceleration time of early filling (DCT-E) and PCWP ( r(2) = 0.899) and deceleration slope of early filling and PCWP (r(2) = 0.692), (P < 0.001 for both). When the relationship between DCT-E and PCWP was tested prospectively in a third group of patients [Group C; EF less than or equal to 35% (n = 16)], a close agreement between the calculated and measured PCWP (bias = -0.55 +/- 3.87 mm Hg) was noted. The sensitivity, specificity, and positive predictive value of DCT-E g reater than or equal to 150 ms for PCWP <10 mm Hg were 93.3%, 100%, an d 100%, respectively. In summary, patients with decreased left ventric ular systolic function undergoing coronary artery surgery demonstrated high, statistically significant, correlations between PCWP and the de celeration time or deceleration slope of early diastolic filling as me asured by transesophageal Doppler echocardiography.