Portal de Periódicos da CAPES

The deceleration time of pulmonary venous diastolic flow is more accurate than the pulmonary artery occlusion pressure in predicting left atrial pressure

2001; Elsevier BV; Volume: 37; Issue: 8 Linguagem: Inglês

10.1016/s0735-1097(01)01294-3

1558-3597

Tim Kinnaird, Christopher Thompson, Bradley Munt,

Cardiovascular Health and Disease Prevention

OBJECTIVES This study compared a prediction of mean left atrial pressure (Pla) ascertained by Doppler echocardiography of pulmonary venous flow (PVF), with predicted Plausing the pulmonary artery occlusion pressure (Ppao). BACKGROUND In select patient groups, PVF variables correlate with Ppao, an indirect measure of Pla. METHODS In 93 patients undergoing cardiac surgery, we recorded with transesophageal echocardiography mitral valve early (E) and late (A) wave velocities, deceleration time (DT) of E (DTe), and pulmonary vein systolic (S) and diastolic (D) wave velocities, DT of D (DTd) and systolic fraction. The Ppaowas measured using a pulmonary artery catheter zeroed to midaxillary level. A further catheter was held at midatrial level to zero a transducer and was then inserted into the left atrium. A prediction rule for Plafrom DTdwas developed in 50 patients and applied prospectively to estimate Plain 43 patients. RESULTS A close correlation (r = −0.92) was found between Plaand DTd. Systolic fraction (r = −0.63), DTe(r = −0.61), D wave (r = 0.57), E wave (r = 0.52), and E/A ratio (r = 0.13) correlated less closely with Pla. The mean difference between predicted and measured Plawas 0.58 mm Hg for DTdmethod and 1.72 mm Hg for Ppao, with limits of agreement (mean ± 2 SE) of −2.94 to 4.10 mm Hg and −2.48 to 5.92 mm Hg, respectively. A DTdof 17 mm Hg. CONCLUSIONS Deceleration time of pulmonary vein diastolic wave is more accurate than Ppaoin estimating left atrial pressure in cardiac surgical patients.