Circulation, Vol 88, 146-155, Copyright © 1993 by American Heart Association
RA Nishimura, RS Schwartz, AJ Tajik and DR Holmes Jr
BACKGROUND. The instantaneous pressure gradient between the left ventricle
and left atrium during systole can be calculated from the mitral
regurgitation Doppler velocity curve. The purpose of our study was to
determine the accuracy of measuring the time constant of relaxation (TAU)
derived from the Doppler mitral regurgitation signal by comparing it with
simultaneous high-fidelity left ventricular pressure measurements in
humans. METHODS AND RESULTS. Twenty-five patients had continuous-wave
Doppler mitral regurgitation recordings performed with simultaneous
high-fidelity left ventricular pressure measurements. Fifteen of these
patients had measurements of six to eight beats at various RR intervals.
Doppler velocity curves were converted to left ventricular pressure curves
by different methods through application of the modified Bernoulli equation
at 3-msec intervals. The correlation between catheter-derived and
Doppler-derived TAU was best when a zero asymptote and knowledge of the
left ventricular end-diastolic pressure were used. A less optimal but
acceptable method used the addition of 20 mm Hg to the Doppler-derived
ventriculoatrial gradient. Use of a nonzero asymptote for calculation of
TAU yielded poor correlation between catheter and Doppler measurements. The
correlation of percentage change in Doppler-derived TAU plotted against
percentage change in catheter-derived TAU was poor. CONCLUSIONS. The
descending limb of the Doppler-derived mitral regurgitation velocity signal
can be used as a semiquantitative estimate of the rate of ventricular
relaxation. This method requires knowledge of left atrial pressure and may
not be sufficiently accurate for detecting small changes in the rate of
relaxation on a beat-to-beat basis.
ARTICLES
Noninvasive measurement of rate of left ventricular relaxation by Doppler echocardiography. Validation with simultaneous cardiac catheterization
Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, MN 55905.
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