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A Novel Method to Estimate Pulmonary Artery Wedge Pressure Using the Downslope of the Doppler Mitral Regurgitant Velocity Profile
Author(s) -
Uzun Mehmet,
Erinc Kursad,
Kirilmaz Ata,
Baysan Oben,
Sag Cemal,
Kilicarslan Fethi,
Genc Celal,
Karaeren Hayrettin,
Demirtas Ertan
Publication year - 2004
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/j.0742-2822.2004.03174.x
Subject(s) - pulmonary wedge pressure , medicine , cardiology , doppler effect , pulmonary artery , mitral regurgitation , pressure gradient , doppler echocardiography , radiology , blood pressure , physics , mechanics , diastole , astronomy
Continuous‐wave (CW) Doppler recording of mitral regurgitation (MR) is a reflection of the left ventriculoatrial pressure gradient. Accordingly, this jet may yield information about pulmonary artery wedge pressure (PAWP). In this study, we derived and then evaluated a novel method for prediction of PAWP. Patients (n = 80) with moderate to severe MR and left ventricular dysfunction were included in the study. Transthoracic echocardiography was performed in patients during pulmonary artery pressure monitoring. A satisfactory CW Doppler recording of MR was obtained in 63/80 (78%). On the late descending portion of the CW recording, the time from a velocity of 4 m/sec to the end of the jet was defined as t 1 , and from 3 m/sec to the end of the jet as t 2 . Mathematical derivation of t 1 /t 2 as a predictor of PAWP, was performed based on Weiss' derivation. If t 1 /t 2 was <1.30, the PAWP was normal. If t 1 /t 2 > 1.44, the PAWP was > 16 mmHg. With this new mathematical derivation, it appears that the downslope of the CW Doppler MR waveform may be able to distinguish a normal from elevated PAWP.