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Titolo:
"Peak summation" left ventricular filling pattern in patients with chronicheart failure: Frequency and complementary value of pulmonary venous flow in its hemodynamic interpretation
Autore:
Capomolla, S; Febo, O; Riccardi, G; Parziale, P; Pinna, G; Opasich, C; Cobelli, F; Tavazzi, L;
Indirizzi:
Salvatore Maugeri Fdn, Inst Med Care & Res, Pavia, Italy Salvatore MaugeriFdn Pavia Italy dn, Inst Med Care & Res, Pavia, Italy
Titolo Testata:
ECHOCARDIOGRAPHY-A JOURNAL OF CARDIOVASCULAR ULTRASOUND AND ALLIED TECHNIQUES
fascicolo: 8, volume: 15, anno: 1998,
parte:, 1
pagine: 721 - 730
SICI:
0742-2822(199811)15:8<721:"SLVFP>2.0.ZU;2-#
Fonte:
ISI
Lingua:
ENG
Soggetto:
DOPPLER-ECHOCARDIOGRAPHIC ASSESSMENT; LEFT ATRIAL PRESSURE; DIASTOLIC FUNCTION; DILATED CARDIOMYOPATHY; MITRAL REGURGITATION; VELOCITY PATTERN; DISEASE;
Keywords:
diastolic function; heart failure; pulmonary venous flow;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
27
Recensione:
Indirizzi per estratti:
Indirizzo: Capomolla, S Montescano Med Ctr, Dept Cardiol, Via Montescano, I-27040 Pavia, Italy Montescano Med Ctr Via Montescano Pavia Italy I-27040 Italy
Citazione:
S. Capomolla et al., ""Peak summation" left ventricular filling pattern in patients with chronicheart failure: Frequency and complementary value of pulmonary venous flow in its hemodynamic interpretation", ECHOCARDIOG, 15(8), 1998, pp. 721-730

Abstract

In patients with chronic heart failure (CHF) and a "peak summation" left ventricular pattern, no hemodynamic and prognostic information can be drawn from Doppler examination of mitral flow. In 263 consecutive patients with CHF who were undergoing simultaneous right heart catheterization and echo-Doppler examination, we prospectively determined (1) the frequency of the peak summation left ventricular filling pattern and (2) the incremental information contributed by pulmonary venous flow velocity patterns in providing noninvasive hemodynamic profile estimation. Isovolumic relaxation time of mitral flow, peak systolic (X), diastolic forward (Y), reverse (Z) flow velocity, and systolic fraction (X/X + Y) of pulmonary venous flow were measured. Forty-six of 263 (17%) patients had a peak summation left ventricular filling pattern. This subgroup showed more clinical deterioration (New York Heart Association functional class III-IV, 57% vs 49%; P < 0.01) and left atrial dysfunction (left atrial ejection fraction, 31% vs 39%; P < 0.001). However, 40% of these patients had a pulmonary wedge pressure of < 18 mmHg anda cardiac index of > 2.2 L/min/m(2). The systolic fraction of peak velocities of pulmonary venous flow skewed a good correlation with pulmonary wedgepressure (r = -0.70, P < 0.05). The correlation was stronger in patients without mitral regurgitation (r = -0.81, P < 0.05). A systolic fraction of <40% was accurate (sensitivity, 100%; specificity, 95%) in identifying patients with a pulmonary wedge pressure of > 18 mmHg. In patients without mitral regurgitation, this variable was also correlated with cardiac index (r =-0.65, P < 0.05) and predicted a cardiac index of > 2.2 L/min/m(2) (sensitivity, 91%; specificity, 71%). In conclusion, a peak summation left ventricular filling pattern is common in patients with CHF. Pulmonary venous flow provides useful information about the hemodynamic profile of these patients.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 14/07/20 alle ore 18:49:35