ESTIMATION OF LEFT-VENTRICULAR DIASTOLIC PRESSURES FROM PRECORDIAL PULSED-DOPPLER ANALYSIS OF PULMONARY VENOUS AND MITRAL FLOW

Because analysis of pulmonary venous flow (PVF) will be extensively us ed in comprehensive Doppler assessment of left ventricular diastolic f unction, this study was designed to (1) evaluate the feasibility of PV F measurement in 116 consecutive patients with various cardiac abnorma lities by using precordial pulsed Doppler echocardiography; (2) Estima te mean pulmonary capillary pressure (MPCP) and left ventricular end-d iastolic pressure (LVEDP) from Doppler variables of PVF and mitral inf low; and (3) evaluate the influence of clinical and hemodynamic variab les on PVF Doppler patterns. We adequately recorded anterograde PVF in 96 (82.7%) patients and retrograde PVF in 45 (38.7%) patients. The st rongest correlation between MPCP and Doppler variables of PVF was foun d with systolic fraction (the systolic velocity time integral expresse d as a fraction of total anterograde PVF) (r = -0.88; p < 0.001). Age influenced this relation, with progressive increase of the systolic fr action in older patients. A good correlation (r = 0.72; p < 0.001) was found between LVEDP and the difference in duration of the reversal PV F and the mitral a wave. In conclusion, (1) PVF can be recorded adequa tely in most patients with precordial Doppler echocardiography; (2) le ft ventricular diastolic pressures can be estimated reliably by precor dial Doppler echocardiography; and(3) the clinical meaning of Doppler- derived indexes of left ventricular diastolic performance is age-relat ed.