Pulmonary venous flow patterns by transesophageal pulsed Doppler echocardiography: Relation to parameters of left ventricular systolic and diastolic function

Kuecherer, Helmut F.; Kusumoto, Fred; Muhiudeen, Isobel A.; Cahalan, Michael K.; Schiller, Nelson B.

doi:10.1016/0002-8703(91)90287-r

Cited by 118 publications

(29 citation statements)

References 39 publications

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“…Attempts to overcome this limitation have involved altering the loading conditions during the Doppler assessment or combining the transmitral variables with pulmonary venous signals. [7][8][9][10]13,14 TDI of the mitral annulus during diastole has been proposed as a new method for assessment cardiac function. With systolic contraction, there is long-axis shortening of the LV manifest by mitral annular descent toward a relatively fixed apex.…”

Section: Discussionmentioning

confidence: 99%

“…3,4 To overcome these limitations of the mitral inflow parameters, combinations of the mitral flow velocity curves with other Doppler parameters have been used. These include the pulmonary venous velocity curves, [5][6][7][8][9][10] color M-mode, 11,12 and the response of the mitral inflow to altered loading conditions. 13,14 Tissue Doppler imaging (TDI) of mitral annular motion has been proposed to correct for the influence of myocardial relaxation on transmitral flows.…”

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confidence: 99%

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Clinical Utility of Doppler Echocardiography and Tissue Doppler Imaging in the Estimation of Left Ventricular Filling Pressures

et al. 2000

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Clinical Utility of Doppler Echocardiography and Tissue Doppler Imaging in the Estimation of Left Ventricular Filling Pressures

et al. 2000

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“…Briefly, not only is the mitral annular descent due to LV systolic dysfunction but also the decrease in LA compliance, based on an increase in LA pressure, is essential for a decrease in PVS 2 in patients with myocardial disease. In fact, PVS 2 and PVS 2 /PVD are negatively correlated with LA pressure [29] (Figure 7), although there is no favorable relationship between PVS 2 and mitral annular descent [30]. One study has reported that a blunted PVF (PVS 2 /PVD < 1) is an important predictor of poor prognosis in patients with LV systolic dysfunction [31], suggesting a close relationship between PVS 2 and LA…”

Section: La Reser Voir Functionmentioning

confidence: 99%

Renewed Interest in Left Atrial Function: What do we Need to Evaluate Clinically?

et al. 2005

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The use of a Swan-Ganz catheter has resulted in the accurate evaluation of the severity of acute left heart failure, making it possible to establish appropriate therapeutic strategies for this disorder using Forrester s classification. The routine use of clinical echocardiography has facilitated the noninvasive diagnosis of hemodynamic abnormalities related to various disease conditions. In particular, transmitral flow (TMF) and pulmonary venous flow (PVF) velocity patterns, acquired by the pulsed Doppler method, have led to the establishment of a new clinical field, diastology [1].Previously, the left ventricle (LV) was the focus of investigation when evaluating left heart function, and the left atrium (LA) was considered to have a minor supporting role. However, recent studies have focused on the role of the LA, because it has been recognized that a thorough understanding of LA performance is essential to evaluate more accurately left heart diseases [2]. When evaluating LV function clinically, hemodynamic abnormalities in the pulmonary vein-LA-LV relationship should always be considered, and echocardiography may be an indispensable tool for obtaining important information concerning the relationship between the pulmonary veins and LV with the LA playing a central role.In this review, we summarize how to evaluate LA function using echocardiography with the role of LA function in patients with left-side heart failure. Basic UnderstandingLeft atrial function is classified into 3 categories based on hemodynamic characteristics [3-6]: 1) reservoir function for blood returning from the pulmonary veins due to active relaxation and passive expansion of the LA during ventricular systole; 2) conduit function promoting direct blood inflow from the pulmonary veins to the LV during ventricular diastole; and 3) booster pump function that is responsible for active ejection of blood into the LV during atrial systole.The blood inflow from the pulmonary veins to the LA and that from the LA to the LV can be evaluated by pulsed Doppler echocardiography based on the PVF velocity pattern (Figure 1, PVF) and the TMF velocity pattern (Figure 1, TMF). Because LA filling and emptying are involved in the hemodynamic relationship between the pulmonary veins, LA and LV, the LA appendage flow velocity pattern (Figure 1, LAAF), recorded by pulsed Doppler echocardiography, and the mitral annular motion velocity pattern (Figure 1, MAMV), recorded by tissue Doppler imaging, also may be important indices for assessing LA function in addition to the LA size determined by M-mode and 2-and 3-dimensional echocardiography, which assess

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“…Studies of diastolic function in adults using M-mode and Doppler echocardiography have shown the usefulness of unidimensional assessment of left atrial dynamics (6), atrioventricular (7)(8)(9) and pulmonary vein flow analysis (10)(11)(12)(13)(14) and, more recently, of tissue Doppler of atrioventricular rings and ventricular septum (15).…”

Section: Introductionmentioning

confidence: 99%

Alternative parameters for echocardiographic assessment of fetal diastolic function

Zielinsky

Nicoloso

Firpo

et al. 2004

Braz J Med Biol Res

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Alternative methods to assess ventricular diastolic function in the fetus are proposed. Fetal myocardial hypertrophy in maternal diabetes was used as a model of decreased left ventricular compliance (LVC), and fetal respiratory movements as a model of increased LVC. Comparison of three groups of fetuses showed that, in 10 fetuses of diabetic mothers (FDM) with septal hypertrophy (SH), the mean excursion index of the septum primum (EISP) (ratio between the linear excursion of the flap valve and the left atrial diameter) was 0.36 ± 0.09, in 8 FDM without SH it was 0.51 ± 0.09 (P = 0.001), and in the 8 normal control fetuses (NCF) it was 0.49 ± 0.12 (P = 0.003). In another study, 28 fetuses in apnea had a mean EISP of 0.39 ± 0.05 which increased to 0.57 ± 0.07 during respiration (P < 0.001). These two studies showed that the mobility of the septum primum was reduced when LVC was decreased and was increased when LVC was enhanced. Mean pulmonary vein pulsatility was higher in 14 FDM (1.83 ± 1.21) than in 26 NCF (1.02 ± 0.31; P = 0.02). In the same fetuses, mean left atrial shortening was decreased (0.40 ± 0.11) in relation to NCF (0.51 ± 0.09; P = 0.011). These results suggest that FDM may have a higher preload than normal controls, probably as a result of increased myocardial mass and LV hypertrophy. Prenatal assessment of LV diastolic function by fetal echocardiography should include analysis of septum primum mobility, pulmonary vein pulsatility, and left atrial shortening.

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Pulmonary venous flow patterns by transesophageal pulsed Doppler echocardiography: Relation to parameters of left ventricular systolic and diastolic function

Cited by 118 publications

References 39 publications

Clinical Utility of Doppler Echocardiography and Tissue Doppler Imaging in the Estimation of Left Ventricular Filling Pressures

Clinical Utility of Doppler Echocardiography and Tissue Doppler Imaging in the Estimation of Left Ventricular Filling Pressures

Renewed Interest in Left Atrial Function: What do we Need to Evaluate Clinically?

Alternative parameters for echocardiographic assessment of fetal diastolic function

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