An index of early left ventricular filling that combined with pulsed Doppler peak E velocity may estimate capillary wedge pressure
An index of early left ventricular filling that combined with pulsed Doppler peak E velocity may estimate capillary wedge pressure
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DOI：
10.1016/s0735-1097(96)00496-2
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发表时间：
1997-02-01
影响因子：
24
通讯作者：
Thomas, JD
中科院分区：
文献类型：
--
作者：
Garcia, MJ;Ares, MA;Thomas, JD
目标。本研究旨在确定从透射多普勒血流和彩色m型多普勒血流传播速度获得的综合信息在估计肺毛细血管楔压方面的适用性。虽然多普勒衍生的左室充盈测量已被用于确定左房压，但其准确性受到心室舒张在这些指标中的可变影响的限制，最近，彩色m型多普勒超声心动图测量的血流传播速度已被建议作为心室舒张的指标。我们研究了45例入住重症监护室接受有创血流动力学监测的患者，我们测量了峰值早期(E)和晚期(A)透射多普勒速度，E/A比和血流传播速度（v(p)），并将其与肺毛细血管楔压（p(w)）进行线性回归比较。我们发现p(w)和E （r = 0.62, p < 0.001）以及E/ a比（r = 0.52, p < 0.001）之间存在适度的正相关，p(w)和v(p)之间存在负相关（r = -0.34, p = 0.02）。通过逐步线性回归，只有E和v(p)是p(w)的有统计学意义的预测因子，但E/v(p)比值提供了p(w)的最佳估计(r = 0.80, p < 0.001; p（w) = 5.27 x [E/v(p)] + 4.6, SEE 3.1 mm Hg）。在早期左室填充期间，通过校正左室弛豫的影响，分量速度(E)与彩色m模式传播速度的比值提供了比透射多普勒血流的标准测量更好的p(w)估计。(C) 1997年由美国心脏病学会发布。
Objectives. This study sought to determine the applicability of the combined information obtained from transmitral Doppler flow and color M-mode Doppler flow propagation velocities for estimating pulmonary capillary wedge pressure.Background. Although Doppler-derived measurements of left ventricular (LV) filling have been applied to determine left atrial pressure, their accuracy has been limited by the variable effect of ventricular relaxation in these indexes, Recently, flow propagation velocity measured by color M-mode Doppler echocardiography has been suggested as an index of ventricular relaxation.Methods. We studied 45 patients admitted to the intensive care unit who underwent invasive hemodynamic monitoring, We measured peak early (E) and late (A) transmitral Doppler velocities, E/A ratio and flow propagation velocity (v(p)) and compared them by linear regression with pulmonary capillary wedge pressure (p(w)).Results. We found a modest positive correlation between p(w) and E (r = 0.62, p < 0.001) and the E/A ratio (r = 0.52, p < 0.001) and a negative correlation between p(w) and v(p) (r = -0.34, p = 0.02). By stepwise linear regression, only E and v(p) were statistically significant predictors of p(w), However, the E/v(p) ratio provided the best estimate of p(w) (r = 0.80, p < 0.001; p(w) = 5.27 x [E/v(p)] + 4.6, SEE 3.1 mm Hg).Conclusions. The ratio of component velocity (E) over the color M-mode propagation velocity during early LV filling, by correcting for the effect of LV relaxation, provides a better estimate of p(w) than standard measurements of transmitral Doppler flow. (C) 1997 by the American College of Cardiology.