Determination of left ventricular end-diastolic pressure using doppler mitral regurgitant gradient: validation by simultaneous catheterization

ABSTRACT

The close relationship between left ventricular end-diastolic [LVEDP] and mean pulmonary artery wedge pressures is widely accepted, and the method for estimating left atrial pressure in patients with mitral regurgitation [MR] using Doppler-echo and systolic blood pressure has been documented. To test the hypothesis which approximate noninvasively LVEDP with mitral regurgitant signal, continuous wave Doppler-echo and dual catheterization were performed simultaneously in 36 patients with MR and normal pulmonary vascular resistance. Doppler-derived LVEDP was calculated by systolic blood pressure minus MR peak gradient. A high correlation [r = 0.942, y = 1.044x -0.057, P <0.001] and a close agreement [d +/- s =0.8 +/- 3.0 mm Hg] were observed between noninvasive and invasive LVEDPs. It is concluded that Doppler-echo coupled with a sphygmomanometry provide a feasible and accurate technique and another important window for the noninvasive assessment of LVEDP