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Influence of Variable Loading Conditions on Pulsed Doppler Indices of Left Ventricular Ejection Dynamics
Author(s) -
LU CHUNZENG,
NICOLOSI GIAN L.,
BURELLI CLAUDIO,
CASSIN MATTEO,
ZARDO FABIO,
BRIEDA MARCO,
CERVESATO EUGENIO,
ZANUTTINI DOMENICO
Publication year - 1994
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.1540-8175.1994.tb01069.x
Subject(s) - ventricle , cardiology , hemodynamics , medicine , doppler echocardiography , ejection fraction , doppler effect , cardiac output , aortic pressure , stroke volume , ventricular pressure , blood pressure , diastole , heart failure , physics , astronomy
To investigate the influence of changes in loading conditions on Doppler echocardiography determination of left ventricular ejection dynamics (peak aortic flow velocity and mean acceleration), pulsed Doppler was performed on 20 patients from apical 5‐chamber view. Doppler aortic flow velocity curves and hemodynamic values (left ventricular pressure, wedge pressure, and cardiac output) and the first derivative of ventricular pressure (dPIdt) by tip‐transducer catheter were simultaneously recorded at baseline and during intravenous infusion of nitroglycerin as well as at baseline and immediately following left ventriculography. During nitroglycerin infusion, the hemodynamic values were reduced and peakdPIdt remained constant, Doppler aortic peak velocity and mean acceleration decreased significantly compared with baseline (0.87 ± 0.11 mlsec vs 1.01 ± 0.14 mlsec and 8.86 ± 1.68 ml sec 2 vs 10.17 ± 1.88 mlsec 2 respectively; bothP < 0.001). After ventriculography, the hemodynamic values increased and peak dPIdt was still constant, Doppler aortic peak velocity and mean acceleration increased significantly compared with baseline (1.15 ± 0.17 mlsec vs 0.98 ± 0.16 mlsec and 11.44 ± 2.06 mlsec 2 vs 9.79 ± 1.88 mlsec 2 respectively;both P < 0.001). In conclusion, left ventricular ejection dynamics, as evaluated by pulsed Doppler echocardiography, is modified by mild changes in loading conditions. Therefore, when serially evaluating the inotropic state of the left ventricle by the Doppler aortic flow velocity pattern, the potential influence of loading conditions should be takeninto account.