Relation of Doppler transmitral flow patterns to functional status in congestive heart failure

Gong Yuan Xie, Martin R. Berk, Mikel D. Smith, Anthony N. DeMaria

Research output: Contribution to journalArticlepeer-review

50 Scopus citations


We analyzed the relation of Doppler transmitral flow patterns and New York Heart Association (NYHA) classification in 60 consecutive patients with heart failure (44 men and 16 women; mean age 58 ± 13 years) with left ventricular ejection fraction of < 40%. Of the study population, 40 patients with mild to moderate heart failure underwent symptom-limited exercise testing. The relation of transmitral flow pattern and exercise tolerance was also analyzed. Doppler echocardiography was performed in all patients. The patients were subdivided into nonrestrictive and restrictive groups according to the pattern. The univariate analysis showed a relation for left ventricular ejection fraction (p = 0.01 by analysis of variance testing) and transmitral flow pattern (p = 0.0003 by chi-squared test) with NYHA classification. When the multivariate regression analysis was performed, only the restrictive pattern by Doppler emerged as an independent determinant of the advanced NYHA class (p = 0.005). In mild to moderate congestive heart failure, patients with nonrestrictive pattern exercised significantly longer than those with the restrictive pattern by an average of 133 seconds (p = 0.003) despite comparable reductions in ejection fraction. Thus the restrictive transmitral flow pattern by Doppler is a noninvasive marker for severe symptoms and diminished exercise tolerance in heart failure patients.

Original languageEnglish
Pages (from-to)766-771
Number of pages6
JournalAmerican Heart Journal
Issue number4
StatePublished - 1996

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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