A simultaneous study of doppler‐echo and catheterization in noninvasive assessment of the left ventricular dp/dt

Abstract

Summary:To confirm the feasibility and accuracy of the method for the noninvasive measurement of the left ventricular dp/dt, 53 patients with mitral regurgitation underwent simultaneous determination of left ventricular dp/dt by continuous-wave Doppler echocardiography and cardiac catheterization. Doppler-determined left ventricular dp/ dt is derived from the Doppler mitral regurgitant spectrum by dividing the magnitude of the left ventricular-atrial pressure gradient rise between 1 and 3 m / s of the mitral regurgitant velocity signal by the time taken for this change. Left ventricular dp/dt by Doppler ranged from 629 to 3494 mmHg/s (Tk SD, 1971 f 785 mmHg/s), and that by catheterization varied between 716 and 3650 mmHg/s (Tk SD, 1974 f 727 mmHg/s). There was a high correlation (r = 0.93, y = 0.862 x + 274.77, SEE = 271 mmHg/s, p<O.OOl) of left ventricular dp/dt between the two techniques. It is concluded that left ventricular dp/dt is one of the most commonly used parameters for the evaluation of left ventricular systolic function and that Doppler echocardiography provides a new, accurate and noninvasive method of evaluation.

Noninvasive estimation of cardiac systolic function using continuous-wave Doppler echocardiography in dogs with experimental mitral regurgitation

“…1,11 D-dP/dt has been demonstrated to be clinically useful in human patients with chronic MR even when it is severe. 1,3,4,9 In our study, MR was severe in Dogs 4 and 5 and in Dog 6. Our study suggests that D-dP/dt is also clinically useful in canine patients without regard to the severity of MR.…”

“…Firstly, D-dP/dt was calculated using an average slope of MR velocity profile in the interval between 1 and 3 m/s. 4,9,10 Secondly, the highest pressure gradient between LV and LA used for the calculation of D-dP/dt was arbitrarily set at 36 mmHg. This occurred earlier than the point from which peak dP/dt was generated, because peak dP/dt usually originated slightly before the time of aortic valve opening.…”

Elongation Index as a New Index Determining the Severity of Left Ventricular Systolic Dysfunction and Mitral Regurgitation in Patients with Congestive Heart Failure

“…Invasive measurement requires catheterization and therefore is not practical. Ge et al 7 proposed a Doppler method, which is more practical in terms of the clinical utility. However, this method necessitates recording of the entire mitral regurgitation envelope.…”

“…The dP/dt was measured from the ascending part of the mitral regurgitation Doppler envelope, as offered by Ge et al 7 …”

“…The formula was LVEF = (EDV − ESV)/EDV. The dP/dt was measured from the ascending part of the mitral regurgitation Doppler envelope, as offered by Ge et al 7 In statistical analysis, Kruskal-Wallis test and Mann-Whitney U tests were used. The statistical significance was set at P value < 0.05.…”