Document Detail

Noninvasive estimation of left ventricular end-diastolic pressure using tissue Doppler imaging combined with pulsed-wave Doppler echocardiography in patients with ventricular septal defects: a comparison with the plasma levels of the B-type natriuretic Peptide.
MedLine Citation:
PMID:  18307440     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: There are limited data regarding whether the ratio of the peak transmitral flow velocity during early diastole (E) to the peak mitral annular velocity during early diastole (Ea) obtained by tissue Doppler imaging (TDI) and the plasma levels of the B-type natriuretic peptide (BNP) are useful for evaluating the left ventricular end-diastolic pressure (LVEDP) in children with ventricular septal defects (VSD). We investigated the validity of noninvasive estimation of the LVEDP in VSD infants. METHODS: We studied 48 patients (mean age, 9 +/- 6 months). Using pulsed-wave Doppler echocardiography and TDI, E and Ea were measured to calculate the E/Ea ratio. The LVEDP and the ratio of pulmonary to systemic blood flow (Qp/Qs) were determined invasively. RESULTS: There were significant positive correlations between E and both the LVEDP value and the Qp/Qs ratio. In contrast, Ea showed significant negative correlations with the LVEDP value and Qp/Qs ratio. The E/Ea ratio correlated significantly with the LVEDP value and Qp/Qs ratio. The plasma BNP levels correlated significantly with the Qp/Qs ratio, although they did not show a significant correlation with the LVEDP. An E/Ea ratio of >9.8 indicated patients with a LVEDP of >10 mmHg with a sensitivity of 92% and specificity of 80%. CONCLUSION: TDI combined with pulsed-wave Doppler echocardiography predicted the LVEDP of VSD infants, whereas the plasma BNP value did not have a significant association with the LVEDP.
Jun Oyamada; Manatomo Toyono; Shunsuke Shimada; Mieko Aoki-Okazaki; Masamichi Tamura; Tsutomu Takahashi; Kenji Harada
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Echocardiography (Mount Kisco, N.Y.)     Volume:  25     ISSN:  0742-2822     ISO Abbreviation:  Echocardiography     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-02-29     Completed Date:  2008-06-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8511187     Medline TA:  Echocardiography     Country:  United States    
Other Details:
Languages:  eng     Pagination:  270-7     Citation Subset:  IM    
Pediatrics, Reproductive and Developmental Medicine, Akita University, Akita, Japan.
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MeSH Terms
Biological Markers / blood
Blood Flow Velocity
Echocardiography, Doppler*
Echocardiography, Doppler, Pulsed*
Heart Catheterization
Heart Septal Defects, Ventricular / physiopathology*,  ultrasonography
Mitral Valve / ultrasonography
Natriuretic Peptide, Brain / blood*
Reproducibility of Results
Ventricular Function, Left*
Ventricular Pressure*
Reg. No./Substance:
0/Biological Markers; 114471-18-0/Natriuretic Peptide, Brain

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