Estimation of left ventricular filling pressures from tissue Doppler

Estimation of left ventricular filling pressures from tissue Doppler

Estimation of left ventricular filling pressures from tissue Doppler data can be obtained from the correlations obtained from previous simultaneous cardiac catheterization and tissue Doppler studies. The ratio of mitral E wave by Doppler to the tissue Doppler derived Ea from the lateral mitral annulus of ten or more indicates elevated left ventricular filling pressures. For the septal region, the corresponding figure is fifteen or more. If the value (of E/Ea) is eight or less, it would suggest a normal left ventricular end diastolic pressure [1].

S F Nagueh, N M Lakkis, K J Middleton, W H Spencer 3rd, W A Zoghbi and M A Quiñones studied thirty five patients with hypertrophic cardiomyopathy with simultaneous cardiac catheterization and echocardiography [2]. The authors concluded that left ventricular filling pressures can be estimated with fair accuracy in patients with hypertrophic cardiomyopathy by measuring E/Ea. Changes in left ventricular filling pressures can also be tracked by changes in the ratio.

Reference

1. Sherif F Nagueh, Christopher P Appleton, Thierry C Gillebert, Paolo N Marino, Jae K Oh, Otto A Smiseth, Alan D Waggoner, Frank A Flachskampf, Patricia A Pellikka, Arturo Evangelisa. Recommendations for the evaluation of left ventricular diastolic function by echocardiography. Eur J Echocardiogr. 2009 Mar;10(2):165-93.
2. S F Nagueh, N M Lakkis, K J Middleton, W H Spencer 3rd, W A Zoghbi, M A Quiñones. Doppler Estimation of Left Ventricular Filling Pressures in Patients With Hypertrophic Cardiomyopathy. Circulation. 1999 Jan 19;99(2):254-61.