Left atrial function in congestive heart failure: Assessment by transmitral and pulmonary vein Doppler

Gong Yuan Xie, Martin R. Berk, Andrew J. Fiedler, Peter M. Sapin, Mikel D. Smith

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

The relation of transmitral flow patterns and pulmonary venous velocities was analyzed from 50 heart failure patients (28 men, 22 women; mean [±SD] age 61 ± 9 years) with a left ventricular ejection fraction < 40%. Doppler echocardiography was performed in all patients. Transmitral flow measurements included early (E) and atrial (A) velocities and deceleration time of E wave (DT). Patients were assigned to two groups according to E/A ratio, DT, or both: 20 patients in the restrictive group, and 30 patients in the nonrestrictive group. Pulmonary venous flow was obtained by the transthoracic approach. Systolic (S), diastolic (D) and atrial reversal (Ar) velocities were measured. Of the study population, 13 patients had simultaneously determined pulmonary capillary wedge pressure (PCWP).The results showed a lower S (28 ± 11 vs. 51 ± 10 cm/sec, p < 0.01), a higher D (66 ± 13 vs. 44 ± 10 cm/sec, p < 0.01) and a smaller Ar (12 ± 10 vs. 24 ±9 cm/sec, p < 0.01) in the restrictive group compared with those in nonrestrictive group. In the subgroup of patients undergoing invasive hemodynamic studies, there was no relationship between PCWP and atrial reversal velocity. However, a significant correlation was observed for pulmonary systolic (r = -0.70, p < 0.01) and diastolic (r = 0.76, p < 0.01) velocities to PCWP. These findings suggest a reduction in left atrial compliance and atrial systolic function and both play important roles in heart failure patients with the restrictive transmitral flow pattern.

Original languageEnglish
Pages (from-to)47-53
Number of pages7
JournalThe International Journal of Cardiac Imaging
Volume14
Issue number1
DOIs
StatePublished - 1998

Keywords

  • Heart failure
  • Pulmonary vein Doppler
  • Transmitral Doppler

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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