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Estimation of LV End‐Diastolic Pressure Using Color‐TDI and Its Application to Noninvasive Quantification of Myocardial Wall Stress
Author(s) -
Moladoust Hassan,
MokhtariDizaji Manijhe,
OjaghiHaghighi Zahra,
Khaledifar Arsalan,
Khajavi Amir
Publication year - 2009
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.1540-8175.2008.00822.x
Subject(s) - preload , cardiology , medicine , diastole , cardiac catheterization , coronary artery disease , doppler imaging , hemodynamics , blood pressure
Background: This study was undertaken to evaluate early‐diastolic annular velocity (Ea) by color‐TDI, combined with the early transmitral filling velocity (E) by pulsed Doppler echocardiography for estimation of left ventricular end diastolic pressure (LVEDP). We applied LVEDP to noninvasive quantification of myocardial wall stress in end‐diastole. Forty‐one coronary artery disease (CAD) patients with sinus rhythm underwent echocardiography and cardiac catheterization evaluated in the study. Methods: First linear regression analysis was performed to assess the relationships between E/Ea and LVEDP. Second LVEDP estimation with these two methods was tested prospectively in 59 additional CAD patients, and average end‐diastolic wall stress was calculated at rest by measuring the principal radii, the thickness of the LV segments, and the estimated LVEDP. The results were compared to the wall stress that was calculated using catheter‐measured LVEDP. Linear regression analysis was performed to assess the relationships between calculated wall stress using Doppler‐estimated LVEDP (WSEP) and calculated wall stress using catheter‐measured LVEDP (WSMP). Results: The results showed that LVEDP had a strong correlation to the lateral E/Ea (r = 0.85; P < 0.001) and medial E/Ea ratios (r = 0.73; P < 0.001). No significant differences were found between the WSEP and WSMP. There were highly significant correlations (at least r = 0.85, P < 0.001) between the WSMP and WSEP at all the myocardial sites. Conclusions: The current data demonstrate that the lateral E/Ea ratio obtained by Doppler echocardiography and color‐TDI is a powerful estimator of LVEDP in CAD patients and provides pressure information required for noninvasive quantification of LV myocardial wall stress with reasonable accuracy in diastole.