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Abstract
Background
Doppler echocardiographic assessment of pulmonary venous flow has helped to characterize left ventricular diastolic function in various cardiac diseases of the heart. Abnormal pulmonary venous flow patterns have been described for a variety of conditions including restrictive myocardial disease such as cardiac amyloidosis, constrictive pericarditis, dilated cardiomyopathy and they also helped to assess the severity of mitral regurgitation. Therefore this study was designed to evaluate the changes of pulmonary venous flow profiles in several cardiac diseases which are commonly encountered clinically, such as congestive heart failure, mitral regurgitation, mitral stenosis, aortic regurgitation and left ventricular hypertrophy and also the differences between right and left pulmonary venous flow pattern in these conditions.
Method
We analyzed transesophageal echocardiographic findings of 328 patients(95 men and 233 women, mean age 54 ± 13 years) in those right and left pulmonary venous flow were obtainable. According to the echocardiographic findings, the above subjects were classified into control group(n=167), congestive heart failure group(n=23), mitral regurgitation group (n = 28) .mitral stenosis group(n=10). aortic regurgitation group(n=37), and left ventricular hypertrophy group(n=23). In this Study, the datas of subjects who did not show significant valvular lesions, ventricular hypertrophy, systolic or diastolic dysfunction were used as a control. Peak systolic velocity(peak S). systolic velocity integral(syst. V.I.), peak diastolic velocity(peak D), diastolic velocity integral (dias. V.I.), peak velocity of atrial contraction (peak A), velocity integral of atrial contraction(A. V.I.), peak systolic velocity/peak diastolic velocity ratio(peak S/peak D), and systolic velocity integral/diastolic velocity integral ratio(syst/dias V.I) were measured in each group.
Results
The pulmonary venous flow pattern of right and left pulmonary vein in each group and comparisons between different groups showed the findings as follows(table).
Conclusion
Analysis of pulmonary venous flow could be used as a useful index of evaluating diseased state of heart. Each group showed the relatively characteristic changes of pulmonary venous flow and those changes could be observed commonly in both right and left pulmonary vein. When one side of pulmonary veins could not be evaluated adequately, the valuable hemodynamic information could be obtained through the examintion of the other side pulmonary vein.
References
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Fig. 1.
This figure shows the location of sample volume in right and left pulmonary vein in transesophageal echocardiography and the Doppler recording of right and left pulmonary venous flow.
Table 1.
Pulmonary venous flow patterns in several cardiac disease
| Control(n=167) | CHF(n=23) | MR(n = 28) | MS(n=10) | AR(n=37) | LVH(n=23) | ||
|---|---|---|---|---|---|---|---|
| RPV | Peak S(cm/sec) | 55.4 ± 14.4 | 40.0 ± 14.9∗∗ | 41.9 ± 21.4∗∗ | 41.1 ± 12.6∗∗ | 50.5 ± 13.8 | 59.3 ± 17.1 |
| Syst V.I.(cm) | 12.1 ± 3.8 | 8.5 ± 3.5∗∗ | 9.0 ± 4.1∗∗ | 6.6 ± 2.2∗∗ | 11.7 ± 3.5 | 12.1 ± 3.9 | |
| Peak D(cm/sec) | 34.4 ± 12.3 | 42.1 ± 20.2 | 39.8 ± 16.7 | 32.7 ± 13.6 | 31.6 ± 10.5 | 31.7 ± 11. | |
| Dias V.I.(cm) | 5.3 ± 2.4 | 7.0 ± 3.4∗ | 6.0 ± 2.6 | 4.4 ± 2.1 | 4.9 ± 2.1 | 5.3 ± 3.1 | |
| Peak A (cm/sec) | 9.4 ± 11.2 | 10.5 ± 11.1 | 11.4 ± 10.6 | 13.6 ± 8.5 | 8.4 ± 9.9 | 15.3 ± 14.2 | |
| A. VI(cm) | 0.7 ± 1.0 | 0.9 ± 1.0 | 0.9 ± 1.0 | 1.0 ± 0.7 | 0.7 ± 1.0 | 1.4 ± 1.4 | |
| Peak S/Peak D | 1.8 ± 1.1 | 1.2 ± 0.7∗∗ | 1.3 ± 1.1∗ | 1.4 ± 0.7 | 1.8 ± 0.8 | 2.2 ± 1.3 | |
| Syst/Dias VI. | 2.8 ± 1.7 | 1.7 ± 1.6∗∗ | 2.1 ± 2.7 | 1.7 ± 0.8∗∗ | 2.8 ± 1.2 | 3.2 ± 2.3 | |
| LPV | Peak S(cm/sec) | 46.4 ± 12.8‡ | 38.5 ± 16.2∗∗ | 39.2 ± 15.5∗∗ | 39.7 ± 19.5 | 46.8 ± 23.9 | 42.3 ± 12.3‡ |
| Syst V.I.(cm) | 11.9 ± 3.4 | 9.3 ± 4.9∗ | 10.3 ± 8.5 | 6.7 ± 2.6∗∗ | 11.1 ± 5.5 | 10.7 ± 4.3 | |
| Peak D(cm/sec) | 27.5 ± 9.0‡ | 35.1 ± 11.8∗∗ | 31.9 ± 8.3∗,† | 29.2 ± 10.7 | 26.2 ± 12.6 | 27.5 ± 12.2 | |
| Dias V.I.(cm) | 4.5 ± 3.1† | 5.3 ± 3.3† | 4.9 ± 2.1 | 4.1 ± 2.0 | 4.3 ± 2.6 | 4.6 ± 2.9 | |
| Peak A (cm/sec) | 8.8 ± 8.9 | 12.5 ± 9.9 | 12.1 ± 9.4 | 19.2 ± 16.2 | 7.8 ± 9.8 | 15.7 ± 10.4∗∗ | |
| A. V.I(cm) | 0.6 ± 0.7 | 0.9 ± 0.9∗ | 0.8 ± 0.8 | 1.4 ± 1.2 | 0.9 ± 1.9 | 1.0± 0.7∗∗ | |
| Peak S/Peak D | 1.8 ± 0.5 | 1.2 ± 0.7∗∗ | 1.3 ± 0.5∗∗ | 1.4 ± 0.4∗ | 2.1 ± 1.1 | 1.7 ± 0.7 | |
| Syst/Dias V.I | 3.3 ± 1.7‡ | 2.3 ± 1.7∗ | 2.3 ± 1.6∗∗ | 1.8 ± 0.6∗∗ | 3.8 ± 3.4 | 3.1 ± 2.1 |
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