Relationship of echocardiographic indices to pulmonary capillary wedge pressures in healthy volunteers

Michael S. Firstenberg, Benjamin D. Levine, Mario J. Garcia, Neil L. Greenberg, Lisa Cardon, Annitta J. Morehead, Julie Zuckerman, James D. Thomas

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205 Scopus citations

Abstract

OBJECTIVES: We sought to determine the relationship between different echocardiographic indices and pulmonary capillary wedge pressures (PCWP) in normal volunteers. BACKGROUND: Indices based on tissue Doppler (TDE) and color M-mode (CMM) echocardiography have been proposed to reflect left (LV) ventricular filling pressures. These include the ratio of early diastolic transmitral velocity (E) to early myocardial velocity measured by TDE (E') and the ratio of E to the wave propagation velocity (Vp) measured from CMM images. These indices, however, have not been validated in normal individuals. METHODS: We studied seven volunteers during two phases of preload altering maneuvers, baseline, with two stages of lower body negative pressure, and repeat baseline with two stages of volume loading. The PCWP obtained from right heart catheterization was compared with diastolic indices using pulsed Doppler, TDE and CMM echocardiography. RESULTS: The PCWP ranged from 2.2 to 23.5 mm Hg. During preload alterations, significant changes in E and septal E' (both p < 0.05) but not lateral E' or Vp were observed. Furthermore, E, septal E' and E/Vp correlated with PCWP (all r > 0.80) but not combined E and TDE indices (both r < 0.15). Within individuals, a similar linear relationship was observed among E/Vp, E and septal E' (average r > 0.80). CONCLUSIONS: In subjects without heart disease, E, septal E' and E/Vp correlate with PCWP. Because the influence of ventricular relaxation is minimized, the ratio E/Vp may be the best overall index of LV filling pressures. (C) 2000 by the American College of Cardiology.

Original languageEnglish (US)
Pages (from-to)1664-1669
Number of pages6
JournalJournal of the American College of Cardiology
Volume36
Issue number5
DOIs
StatePublished - Nov 1 2000

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ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Firstenberg, M. S., Levine, B. D., Garcia, M. J., Greenberg, N. L., Cardon, L., Morehead, A. J., Zuckerman, J., & Thomas, J. D. (2000). Relationship of echocardiographic indices to pulmonary capillary wedge pressures in healthy volunteers. Journal of the American College of Cardiology, 36(5), 1664-1669. https://doi.org/10.1016/S0735-1097(00)00909-8