Echocardiographic Indices Associated with Left Ventricular End-Diastolic Pressure

ABSTRACT

BACKGROUND AND OBJECTIVES: It has been suggested that the indices based on tissue doppler and color M-mode echocardiography reflect the left ventricular end-diastolic pressure. These include the early diastolic transmitral velocity (E) to early myocardial velocity ratio measured by tissue doppler (E') and the E to the wave propagation velocity (Vp) ratio measured from color M-mode images. However, these indices have not been well validated in congestive heart failure patients. SUBJECTS AND METHODS:Thirty one congestive heart failure patients who underwent simultaneous cardiac catheterization and echocardiography, and had normal sinus rhythm were enrolled in this study. The left ventricular end-diastolic pressure obtained from the left heart catheterization was compared with the diastolic indices using pulsed doppler, tissue doppler and color M-mode echocardiography. RESULTS: The left ventricular end-diastolic pressure (LVEDP) ranged from 3.3 to 23 mmHg. Some parameters showed a significant correlation with the LVEDP. The propagation velocity showed a significant correlation with the LVEDP (r=0.382, p=0.034), and the E to propagation velocity ratio (E/Vp) showed a good correlation with the LVEDP(r=0.408, p=0.023). In addition, the E to early diastolic velocity of the mitral annulus (E') ratio had an insignificant correlation with the LVEDP(r=0.322, p=0.078). Among the patients with ischemic congestive heart failure, the E to the propagation velocity ratio (E/Vp) showed a marginal correlation with the LVEDP (r=0.461, p=0.047). CONCLUSION: In patients with congestive heart failure, the Vp and E/Vp showed a good correlation with the LVEDP. In the subgroup of patients with ischemic congestive heart failure, only the E/Vp showed a significant correlation with the LVEDP.