OBJECTIVES: We sought a noninvasive estimation of pulmonary capillary wedge pressure (Pw) by means of the information obtained from transmitral pulsed Doppler and color M-mode Doppler flow propagation velocity (FPV). BACKGROUND: Pulsed Doppler parameters have limited accuracy for the estimation of Pw because they are determined by left atrial pressure and other parameters such as ventricular relaxation. Recently, a good correlation has been found between the rate of ventricular relaxation (tau, tau) and FPV measured by color M-mode Doppler echocardiography. METHODS: We studied 20 patients who underwent invasive hemodynamic monitoring. By multilinear regression analysis, the relationships between Pw and Doppler parameters, FPV, and a noninvasive estimate (P(est)) based on the Weiss' equation (substituting tau for 1/FPV) were determined. A simplified index based on the results obtained was then tested in an additional group of 34 patients. RESULTS: By multiple regression analysis only isovolumic relaxation time (IVRT) (p = 0.0096) and P(est) (p = 0.0043) were related to Pw. A derived empirical index, 10(3)/([2 x IVRT] + FPV), was strongly correlated with Pw in the entire group according to the regression equation Pw = 4.5 x (10(3)/[[2 x IVRT] + FPV]) - 9 (r = 0.89, p < 0.0001, [standard error of the estimate] SEE = 3.3 mm Hg). The sensitivity and specificity for the prediction of Pw > 15 mm Hg were 90% and 100%, respectively. CONCLUSIONS: The combined use of FPV as a surrogate for tau and IVRT permits a close prediction of Pw.
OBJECTIVES: We sought a noninvasive estimation of pulmonary capillary wedge pressure (Pw) by means of the information obtained from transmitral pulsed Doppler and color M-mode Doppler flow propagation velocity (FPV). BACKGROUND: Pulsed Doppler parameters have limited accuracy for the estimation of Pw because they are determined by left atrial pressure and other parameters such as ventricular relaxation. Recently, a good correlation has been found between the rate of ventricular relaxation (tau, tau) and FPV measured by color M-mode Doppler echocardiography. METHODS: We studied 20 patients who underwent invasive hemodynamic monitoring. By multilinear regression analysis, the relationships between Pw and Doppler parameters, FPV, and a noninvasive estimate (P(est)) based on the Weiss' equation (substituting tau for 1/FPV) were determined. A simplified index based on the results obtained was then tested in an additional group of 34 patients. RESULTS: By multiple regression analysis only isovolumic relaxation time (IVRT) (p = 0.0096) and P(est) (p = 0.0043) were related to Pw. A derived empirical index, 10(3)/([2 x IVRT] + FPV), was strongly correlated with Pw in the entire group according to the regression equation Pw = 4.5 x (10(3)/[[2 x IVRT] + FPV]) - 9 (r = 0.89, p < 0.0001, [standard error of the estimate] SEE = 3.3 mm Hg). The sensitivity and specificity for the prediction of Pw > 15 mm Hg were 90% and 100%, respectively. CONCLUSIONS: The combined use of FPV as a surrogate for tau and IVRT permits a close prediction of Pw.
Authors: Andrew D Feingold; Dennis A Tighe; Gerard P Aurigemma; Jeffrey C Hill; Craig S Vinch Journal: Curr Cardiol Rep Date: 2004-05 Impact factor: 2.931
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Authors: J I Alonso-Fernández; J R Prieto-Recio; C García-Bernardo; I García-Saiz; J Rico-Feijoo; C Aldecoa Journal: Case Rep Crit Care Date: 2015-10-28