TY - JOUR
T1 - Estimation of left and right ventricular filling pressures after heart transplantation by tissue doppler imaging
AU - Sundereswaran, Lalitha
AU - Nagueh, Sherif
AU - Vardan, Sandeep
AU - Middleton, Katherine J.
AU - Zoghbi, William A.
AU - Quiñones, Miguel A.
AU - Torre, Guillermo
PY - 1998/8/17
Y1 - 1998/8/17
N2 - Current Doppler methods have been unreliable in estimating filling pressures in heart transplants. Tissue Doppler imaging is a technique that permits evaluation of myocardial relaxation; combined with transvalvular E velocity, it could improve estimation of these pressures. To investigate this possibility, we evaluated 50 patients by right-sided cardiac catheterization and Doppler echocardiography simultaneously. Their mean ±SD age was 53 ± 15 years and the mean age of donor hearts was 30 ± 12.5 years. The mitral E velocity was combined with the early myocardial relaxation (Ea) velocity by tissue Doppler at the lateral border of the mitral annulus. Likewise, the tricuspid E velocity was combined with Ea at the lateral corner of the tricuspid annulus. Mean wedge pressure related weakly to mitral inflow variables but strongly to E/Ea [r = 0.8; wedge pressure = 2.6 + 1.46(E/Ea)]. In 25 repeat right-sided cardiac catheterizations, changes in mean wedge pressure were well detected by Doppler, with a mean difference of -0.7 ± 3 mm Hg. Mean right atrial pressure related weakly to routine tricuspid inflow variables but strongly to tricuspid E/Ea [r = 0.79; n = 38; right atrial pressure = 1.76(E/Ea) 3.7]. In 18 repeat right-sided cardiac catheterizations, changes in mean right atrial pressure were well detected by Doppler, with a mean difference of 0 ± 3.45 mm Hg. Mean wedge pressure and mean right atrial pressure can be estimated in heart transplants with reasonable accuracy using the ratio of E/Ea. Furthermore, this method can accurately track changes in filling pressures.
AB - Current Doppler methods have been unreliable in estimating filling pressures in heart transplants. Tissue Doppler imaging is a technique that permits evaluation of myocardial relaxation; combined with transvalvular E velocity, it could improve estimation of these pressures. To investigate this possibility, we evaluated 50 patients by right-sided cardiac catheterization and Doppler echocardiography simultaneously. Their mean ±SD age was 53 ± 15 years and the mean age of donor hearts was 30 ± 12.5 years. The mitral E velocity was combined with the early myocardial relaxation (Ea) velocity by tissue Doppler at the lateral border of the mitral annulus. Likewise, the tricuspid E velocity was combined with Ea at the lateral corner of the tricuspid annulus. Mean wedge pressure related weakly to mitral inflow variables but strongly to E/Ea [r = 0.8; wedge pressure = 2.6 + 1.46(E/Ea)]. In 25 repeat right-sided cardiac catheterizations, changes in mean wedge pressure were well detected by Doppler, with a mean difference of -0.7 ± 3 mm Hg. Mean right atrial pressure related weakly to routine tricuspid inflow variables but strongly to tricuspid E/Ea [r = 0.79; n = 38; right atrial pressure = 1.76(E/Ea) 3.7]. In 18 repeat right-sided cardiac catheterizations, changes in mean right atrial pressure were well detected by Doppler, with a mean difference of 0 ± 3.45 mm Hg. Mean wedge pressure and mean right atrial pressure can be estimated in heart transplants with reasonable accuracy using the ratio of E/Ea. Furthermore, this method can accurately track changes in filling pressures.
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U2 - 10.1016/S0002-9149(98)00346-4
DO - 10.1016/S0002-9149(98)00346-4
M3 - Article
C2 - 9708666
AN - SCOPUS:0031880249
VL - 82
SP - 352
EP - 357
JO - American Journal of Cardiology
JF - American Journal of Cardiology
SN - 0002-9149
IS - 3
ER -