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(Circulation. 2005;111:3192-3194.)
© 2005 American Heart Association, Inc.

Editorial

Echocardiography as a Noninvasive Swan-Ganz Catheter

Jae K. Oh, MD

From the Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minn.

Correspondence to Dr Jae K. Oh, Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic College of Medicine, 200 First St SW, Rochester, MN 55905. E-mail oh.jae@mayo.edu

Key Words: Editorials • echocardiography • mitral valve • diastole • intervals

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Diwan and co-investigators report in this issue of Circulation that the interval between onset of mitral E and annular early diastolic velocity (Ea) by tissue Doppler, T_E–Ea, can be used to estimate left ventricular (LV) filling pressure in patients with mitral valve disease.¹ Garcia and colleagues were the first to report that the onset of Ea occurred 7.5±3.5 ms after peak mitral inflow velocity in 7 patients with restrictive cardiomyopathy, whereas Ea started 22±19 ms earlier than did E in the normal group.² Subsequently, T_E–Ea has been shown to correlate with the time constant of LV relaxation () demonstrated by Hasegawa and associates in their elegant animal experiment.³ With worsening of heart failure by rapid pacing, Ea progressively decreased in velocity and delayed in onset. Mitral E occurred coincidently with the termination of the early diastolic left arterial (LA) and LV pressure gradient at baseline and all stages of heart failure. In contrast, with increasing heart failure, Ea was progressively delayed after LA to LV pressure crossover, and T_E–Ea was related to . Rivas-Gotz, Nagueh, and their associates also demonstrated that T_E–Ea was prolonged after constriction of the circumflex coronary artery in dogs.⁴ In patients with heart failure, LV myocardial relaxation and compliance are decreased.

See p 3281

Although LV filling is initiated and enhanced by augmentable myocardial relaxation in healthy individuals, it is driven by high filling pressure in patients with heart failure because myocardial relaxation remains reduced, not being sensitive to preload. Myocardial relaxation also affects . . . [Full Text of this Article]

Related Article:

Doppler Estimation of Left Ventricular Filling Pressures in Patients With Mitral Valve Disease

Abhvinav Diwan, Marti McCulloch, Gerald M. Lawrie, Michael J. Reardon, and Sherif F. Nagueh
Circulation 2005 111: 3281-3289. [Abstract] [Full Text]

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				J.K. Oh Echocardiography in heart failure: Beyond diagnosis Eur J Echocardiogr, January 1, 2007; 8(1): 4 - 14. [Full Text] [PDF]

				J.-O. Choi, S.-C. Lee, S. W. Park, A. Diwan, M. McCulloch, G. M. Lawrie, M. J. Reardon, and S. F. Nagueh Letter Regarding Article by Diwan et al, "Doppler Estimation of Left Ventricular Filling Pressures in Patients With Mitral Valve Disease" * Response Circulation, November 8, 2005; 112(19): e317 - e317. [Full Text] [PDF]