Instantaneous diastolic transmitral pressure differences from color Doppler M mode echocardiography

Neil L. Greenberg*, Pieter M. Vandervoort, James D. Thomas

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

57 Scopus citations

Abstract

Pulsed and continuous wave Doppler velocity measurements are routinely used in clinical practice to assess severity of stenotic and regurgitant valves or to estimate intracavitary pressures. However, this method only evaluates the convective component of the pressure gradient (based on the velocity measurements) and neglects the contribution of inertial forces that can be important, in particular for flow across nonstenotic valves. Digital processing of color Doppler ultrasound data was used to noninvasively estimate both the convective and inertial components of the transmittal pressure difference. Simultaneous pressure and velocity measurements were obtained in six anesthetized open-chest dogs. The instantaneous diastolic transmittal pressure difference is computed from the M mode spatiotemporal velocity distribution using the unsteady flow form of the Bernoulli equation. The inclusion of the inertial forces ([ΔP1](max) = 0.90 ± 0.30 mmHg) in the noninvasive pressure difference calculation significantly increased the correlation with catheter-based measurement (r = 0.15 ± 0.23 vs. 0.85 ± 0.08; P < 0.0001) and also allowed an accurate approximation of the peak early filling pressure difference [[ΔP(C + 1)](max) = 0.95[ΔP(cath)](max) + 0.07, r = 0.92, P < 0.001, error: ε(C + 1) ([ΔP(C + 1)](max) - [ΔP(cath)](max)) = 0.01 ± 0.24 mmHg, N = 90]. Noninvasive estimation of left ventricular filling pressure differences using this technique will improve the understanding of diastolic filling and function of the heart.

Original languageEnglish (US)
JournalAmerican Journal of Physiology - Heart and Circulatory Physiology
Volume271
Issue number4 40-4
StatePublished - Oct 1 1996

Keywords

  • diastolic function
  • fluid dynamics
  • spatiotemporal velocity distribution
  • transvalvular pressure gradient
  • ventricular filling

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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