Echophonocardiographic estimates of pulmonary artery wedge pressure in mitral stenosis

Rahko, Peter S.; Shaver, James A.; Salerni, Rosemarie; Gamble, William H.; Reddy, P S

doi:10.1016/0002-9149(85)90394-7

Cited by 10 publications

(13 citation statements)

References 27 publications

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“…The A2E interval relationship to the left ventricular filling pressure has been considerably stronger with the QC/A2E ratio having the strongest relationship [1][2][3]. Our data appear to indicate that the QC interval is unaffected by the induction of left ventric ular dysfunction or by alterations of left ventricular fill ing pressure.…”

Section: Discussionmentioning

confidence: 57%

“…Under these circumstances, the increased left atrial pressure would then be associ ated with a significant v wave which would effectively shorten the timing interval between left ventricular pres sure at aortic valve closure and the left ventricular-left atrial pressure crossover point and the noninvasively determined isovolumic relaxation period and A2E inter val [3]. Potential alterations in these timing intervals due to mitral regurgitation might be somewhat offset by the changes in these intervals due to abnormal relaxation.…”

Section: Discussionmentioning

confidence: 99%

“…Potential alterations in these timing intervals due to mitral regurgitation might be somewhat offset by the changes in these intervals due to abnormal relaxation. However, the greatest utility of these intervals may be in a circumstance where relaxation abnormalities were sta ble and alterations in left atrial pressure could be re flected by changes in the height of the left atrial v wave [3]. Dilated congestive heart failure may represent the ideal clinical situation.…”

Section: Discussionmentioning

confidence: 99%

“…Despite the good correlation of this ratio with the mean pulmonary capillary pressure in the resting state, only one study [3] has demonstrated a moderate relation between the change in the pulmonary capillary pressure with the change in the QC/A2E ratio. For this ratio to be useful in predicting the left ventricular filling pressure and its alterations, it will need to reflect changes in the left ventricular filling pressure during the treatment of congestive heart failure or during the treatment of isch emic heart disease.…”

Section: Introductionmentioning

confidence: 94%

“…Since the isovolumic relaxation period (the aortic valve closure to mitral valve opening interval) is prolonged in acute ischemia and in chronic coronary disease, one would predict that the A2E interval also would be pro longed, especially in patients who have active ischemia and elevated left ventricular filling pressures. To further obfuscate matters, mitral regurgitation tends to shorten the A2E interval [3], Because of the lack of systematic studies evaluating the utility of these intervals in a heter ogeneous group of patients at rest and during interven tions that alter left ventricular filling pressures, we un dertook a systematic evaluation of these intervals utiliz ing a canine model of acute left ventricular dysfunction associated with left ventricular filling pressure elevation. This canine model utilizes diffuse coronary emboliza tion resulting in ischemia as a means of producing left ventricular dysfunction and elevation of the left ventric ular filling pressures [6].…”

Section: Introductionmentioning

confidence: 99%

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Utility of Echophonocardiographic Timing Intervals for the Prediction of Left Ventricular Filling Pressures

Lavine¹,

Held²,

Campbell³

et al. 1989

Am J Noninvas Cardiol

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Recent evidence has suggested that the left ventricular (LV) filling pressure can be estimated from echophonocardiographic recordings of the aortic component of the 2nd heart sound and the mitral valve echogram. The ratio of the Q wave to the closure point of the mitral valve (QC) and the time interval from the A2 to the E point of the mitral valve (A2E) have been demonstrated to increase with increasing LV filling pressures. However, with active coronary ischemia, the isovolumic relaxation period becomes prolonged which may prolong the A2E interval. In this study we systematically evaluated the QC and A2E intervals using a canine model of acute LV dysfunction associated with elevation of LV filling pressures. Coronary artery microsphere embolization was used to induce global LV dysfunction and ischemia. Acute LV dysfunction did not alter the QC interval, but lengthened the A2E interval (baseline 94 ±31 ms, severe LV dysfunction 128 ± 27 ms; p < 0.01). The QC/A2E ratio shortened with LV dysfunction (baseline 0.43 ± 0.19, severe LV dysfunction 0.32 ± 13; p < 0.01). No significant relation was noted between the QC/A2E ratio and the LV end-diastolic or minimal pressure. To further alter LV filling pressures, nitroglycerin and nitroprusside were used to reduce the LV end-diastolic pressure to < 15 mm Hg. The QC interval was unchanged with either agent. The A2E interval shortened, while the time constant of relaxation and the isovolumic relaxation period also shortened. We conclude that the QC/A2E ratio is not useful in predicting the LV filling pressures. Furthermore, alterations in the A2E interval reflect alterations in LV relaxation.

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Section: Discussionmentioning

confidence: 57%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Utility of Echophonocardiographic Timing Intervals for the Prediction of Left Ventricular Filling Pressures

Lavine¹,

Held²,

Campbell³

et al. 1989

Am J Noninvas Cardiol

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Echocardiographic estimate of left atrial pressure in children

et al. 1987

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Echocardiographic estimates of left atrial pressure using the Q-MVC/AVC-E ratio were obtained from 21 patients in the early postoperative period and compared to simultaneously recorded mean left atrial pressure. A good correlation was obtained between mean left atrial pressure and the Q-MVC/AVC-E ratio (r = 0.81, p less than 0.001) with a regression equation of: left atrial pressure = 11.09 (Q-MVC/AVC-E) + 0.84. The present data compared to those of previous investigators reveal that, although there are quantitative differences between each of the studies, the correlation coefficient of each study is good. Echocardiography provides a useful noninvasive estimate the left atrial pressure; however, each laboratory must establish its own normals.

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Echocardiographic estimate of left atrial pressure in children

Wang¹,

Cheng²,

Gao

1992

Journal of Tongji Medical University

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Echocardiographic estimates of left atrial pressure (LAP) using the Q-C/A2-E ratio were obtained from 40 patients and compared with directly recorded mean LAP and/or pulmonary wedge pressure (PWP). The best correlation was obtained between LAP and the Q-C/A2-E (gamma = 0.95, P < 0.01); a good one between PWP and the Q-C/A2-E in normal and moderate pulmonary hypertension (gamma = 0.82, P < 0.01), but a poor one in severe pulmonary hypertension (gamma = 0.61, P > 0.05). Consequently, echocardiography provides a useful noninvasive method for the estimation of the LAP and PWP, particularly appropriate for children Intensive Care Unit.

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Echophonocardiographic estimates of pulmonary artery wedge pressure in mitral stenosis

Cited by 10 publications

References 27 publications

Utility of Echophonocardiographic Timing Intervals for the Prediction of Left Ventricular Filling Pressures

Utility of Echophonocardiographic Timing Intervals for the Prediction of Left Ventricular Filling Pressures

Echocardiographic estimate of left atrial pressure in children

Echocardiographic estimate of left atrial pressure in children

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