Clinical Utility of Doppler Echocardiography and Tissue Doppler Imaging in the Estimation of Left Ventricular Filling Pressures: A Comparative Simultaneous Doppler-Catheterization Study
Abstract
Background —Noninvasive assessment of diastolic filling by Doppler echocardiography provides important information about left ventricular (LV) status in selected subsets of patients. This study was designed to assess whether mitral annular velocities as assessed by tissue Doppler imaging are associated with invasive measures of diastolic LV performance and whether additional information is gained over traditional Doppler variables. Methods and Results —One hundred consecutive patients referred for cardiac catheterization underwent simultaneous Doppler interrogation. Invasive measurements of LV pressures were obtained with micromanometer-tipped catheters, and the mean LV diastolic pressure (M-LVDP) was used as a surrogate for mean left atrial pressure. Doppler signals from the mitral inflow, pulmonary venous inflow, and TDI of the mitral annulus were obtained. Isolated parameters of transmitral flow correlated with M-LVDP only when ejection fraction <50%. The ratio of mitral velocity to early diastolic velocity of the mitral annulus (E/E′) showed a better correlation with M-LVDP than did other Doppler variables for all levels of systolic function. E/E′ <8 accurately predicted normal M-LVDP, and E/E′ >15 identified increased M-LVDP. Wide variability was present in those with E/E′ of 8 to 15. A subset of those patients with E/E′ 8 to 15 could be further defined by use of other Doppler data. Conclusions —The combination of tissue Doppler imaging of the mitral annulus and mitral inflow velocity curves provides better estimates of LV filling pressures than other methods (pulmonary vein, preload reduction). However, accurate prediction of filling pressures for an individual patient requires a stepwise approach incorporating all available data.
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The ratio of the mitral E-wave velocity to the early diastolic mitral annular tissue velocity (E′) is a well validated index of pulmonary capillary wedge pressure.
“The ratio of the mitral E-wave velocity to the early diastolic mitral annular tissue velocity (E′) is a well validated index of pulmonary capillary wedge pressure (87, 264).”
From Cardiac remodeling in obesity (2008) · cites this paper as [264]
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- Authors
- Ommen, S. R., Nishimura, R. A., Appleton, C. P., Miller, F. A., Oh, J. K., Redfield, M. M., & Tajik, A. J.
- Affiliations
- Mayo Clinic (US)
- Venue
- Circulation
- Published
- 2000-10-10
- Volume
- 102
- Issue
- 15
- Pages
- 1788-1794
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W1999291203
- Cited by
- 2,790
- References
- 37
- Citations by year
- 2026: 35 · 2025: 41 · 2024: 52 · 2023: 51 · 2022: 60 · 2021: 73 · 2020: 97 · 2019: 81 · 2018: 88 · 2017: 116 · 2016: 132 · 2015: 176 · 2014: 150 · 2013: 181 · 2012: 171
- FWCI
- 17.10
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Valve Diseases and Treatments
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiac Imaging and Diagnostics
- Keywords
- left ventricular filling pressure, tissue Doppler imaging, mitral annular velocity, diastolic function, E/e' ratio, mitral inflow velocity, left ventricular diastolic pressure, left atrial pressure
- MeSH terms
- Aged, Diastole, Female, Heart, Humans, Male, Middle Aged, Echocardiography, Doppler, Ventricular Function, Ventricular Function, Left
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