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- Title
A Novel Noninvasive Method to Assess Left Ventricular −dP/dt Using Diastolic Blood Pressure and Isovolumic Relaxation Time.
- Authors
Parekh, Rupal; Kolias, Theodore J.
- Abstract
Background: Left ventricular Doppler-derived −dP/dt determined from the continuous-wave Doppler spectrum of the mitral regurgitation ( MR) jet has been shown to be a valuable marker of diastolic function, but requires the presence of MR for its assessment. We sought to determine if a novel method of determining −dP/dt using the diastolic blood pressure and isovolumic relaxation time ( DBP- IVRT method) correlates with Doppler-derived −dP/dt using the MR method ( Doppler- MR method). Methods: Thirty-three patients with less than severe MR were enrolled. −dP/dt was determined using the Doppler- MR method from the continuous-wave Doppler spectrum of the MR jet (32 mmHg/time from 3 to 1 m/sec). −dP/dt was also determined using the DBP- IVRT method using the following equation: −dP/dt = ( DBP − LVEDP)/ IVRT, where left ventricular end-diastolic pressure ( LVEDP) was estimated based on tissue Doppler and mitral inflow patterns. Results: Twenty-five patients had adequate Doppler waveforms for analysis. The average amount of MR was mild-to-moderate severity. The mean −dP/dt was 680 ± 201 mmHg by the Doppler- MR method and 681 ± 237 mmHg by the DBP- IVRT method. There was a significant correlation between the 2 methods of determining −dP/dt (Pearson r = 0.574, P = 0.003). The Bland-Altman plot revealed almost no bias between the 2 methods; the difference in −dP/dt between the 2 techniques was noted to be greater for patients with higher −dP/dt, however. Conclusion: Diastolic blood pressure and isovolumic relaxation time may be used to noninvasively assess diastolic function in patients who do not have MR, especially in those with reduced diastolic function.
- Publication
Echocardiography, 2013, Vol 30, Issue 3, p267
- ISSN
0742-2822
- Publication type
Journal Article
- DOI
10.1111/echo.12042