Original articleAbnormal Septal Motion Affects Early Diastolic Velocities at the Septal And Lateral Mitral Annulus, and Impacts on Estimation of the Pulmonary Capillary Wedge Pressure
Section snippets
Patient demographics
In all, 50 patients admitted to the intensive care unit at either study institution were prospectively included in this study. The human research ethics committees at both hospitals approved this study, and written informed consent was obtained from each patient or their next of kin. Patients were included if a pulmonary artery catheter was inserted as part of their routine medical care. Exclusion criteria included the presence of atrial fibrillation; mitral valve stenosis, mitral valve
Population characteristics
Of the initial population of 50 patients, 14 patients had NSM and 36 patients had ASM. Patients with NSM were in the intensive care unit because of complex medical (sepsis in two patients, pneumonia in four, multiorgan failure in one, decompensated liver disease in one, pancreatitis in one, acute pulmonary edema in one, cardiogenic shock in one) or surgical (post liver transplant in one patient, and ruptured abdominal aortic aneurysm in two) problems.
All patients with ASM on echocardiography
Discussion
This study demonstrates that in the noninvasive assessment of PCWP for patients who are critically ill, ASM renders the E/Ea ratio unreliable when measured at either the septal or the lateral mitral annulus. In the patient group with NSM, the E/Ea ratio measured at the septal and lateral mitral annulus correlated well with invasively measured PCWP and may be useful in the noninvasive estimation of PCWP in the future in patients who are critically ill. In this study, the Doppler-derived PCWP
References (30)
- et al.
Clinical, radiographic, and hemodynamic correlations in chronic congestive heart failureconflicting results may lead to inappropriate care
Am J Med
(1991) - et al.
Doppler tissue imaginga noninvasive technique for evaluation of left ventricular relaxation and estimation of filling pressures
J Am Coll Cardiol
(1997) - et al.
An index of early left ventricular filling that combined with pulsed Doppler peak E velocity may estimate capillary wedge pressure
J Am Coll Cardiol
(1997) - et al.
Differentiation of constrictive pericarditis from restrictive cardiomyopathyassessment of left ventricular diastolic velocities in longitudinal axis by Doppler tissue imaging
J Am Coll Cardiol
(1996) - et al.
Feasibility and accuracy of Doppler echocardiographic estimation of pulmonary artery occlusive pressure in the intensive care unit
Am J Cardiol
(1995) - et al.
Mechanisms of the development and resolution of paradoxical interventricular septal motion after uncomplicated cardiac surgery
Am Heart J
(1987) - et al.
Interventricular septal motion and left ventricular function after coronary bypass surgeryevaluation with echocardiography and radionuclide angiography
Am J Cardiol
(1977) - et al.
Abnormal interventricular septal motion following cardiac surgeryclinical, surgical, echocardiographic and radionuclide correlates
Am Heart J
(1979) - et al.
Systolic excursion of the mitral annulus to assess septal function in paradoxic septal motion
Am Heart J
(1996) - et al.
Evaluation of abnormal motion of interventricular septum after coronary artery bypass grafting operationassessment by ultrasonic strain rate imaging
J Am Soc Echocardiogr
(2004)
Effect of the isolated left bundle branch block on systolic and diastolic functions of left ventricle
J Am Soc Echocardiogr
Left ventricular Doppler diastolic filling patterns in patients with isolated left bundle branch block
Am J Cardiol
An evaluation of the use of new Doppler methods for detecting longitudinal function abnormalities in a pacing-induced heart failure model
J Am Soc Echocardiogr
Abnormal postoperative interventricular motionnew intraoperative transesophageal echocardiographic evidence supports a novel hypothesis
Am Heart J
Does positive end-expiratory pressure ventilation improve left ventricular function? A comparative study by transesophageal echocardiography in cardiac and noncardiac patients
Chest
Cited by (0)
This work was supported in part by a Project Grant from the National Heart Foundation of Australia (G01M0312). Dr D’Souza is the recipient of a Medical Postgraduate Research Fellowship from the National Health and Medical Research Council of Australia.