Circulation, Vol 82, 514-520, Copyright © 1990 by American Heart Association
RG Pai, RC Bansal and PM Shah
A new Doppler-derived index of the rate of left ventricular (LV) pressure
rise (delta P/delta t) was evaluated for the prognostic stratification of
patients with chronic mitral regurgitation. The index is derived from the
continuous wave Doppler mitral regurgitation signal by dividing magnitude
of LV-left atrial pressure gradient rise (delta p) between 1 and 3 m/sec of
the mitral regurgitation velocity signal by the time taken (delta t) for
this change. We studied the LV delta P/delta t and other echocardiographic
indexes of LV function before and after mitral valve surgery in 25 patients
with chronic, severe mitral regurgitation in the absence of significant
coronary artery disease. There was a good correlation between postoperative
ejection fraction (EF) and the derived LV delta P/delta t (r = 0.75, p less
than 0.001). The other echocardiographic parameters that correlated with
postoperative EF were LV end-systolic dimension (r = -0.7, p less than
0.001), end-systolic volume (r = -0.69, p less than 0.001), end- diastolic
dimension (r = -0.58, p less than 0.01), end-diastolic volume (r = -0.57, p
less than 0.01), preoperative EF (r = 0.69, p less than 0.001),
end-systolic wall stress (r = -0.61, p less than 0.01), and end- systolic
wall stress normalized for end-systolic volume index (r = - 0.45, p less
than 0.05). With multiple regression, the LV delta P/delta t and LV
end-systolic dimension (ESD) were shown to be independent predictors of
postoperative EF. The postoperative EF could defined by the equation: 43 +
0.8 square root delta P/delta t--0.53 ESD (mm) (r = 0.86).(ABSTRACT
TRUNCATED AT 250 WORDS)
ARTICLES
Doppler-derived rate of left ventricular pressure rise. Its correlation with the postoperative left ventricular function in mitral regurgitation
Department of Medicine, Loma Linda University Medical Center, CA 92354.
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