PMID: 9191486Oct 1, 1996Paper

Doppler-derived diastolic indices in dilated cardiomyopathy: a hemodynamic evaluation relating pre- and afterload parameters to flow velocity

The Canadian Journal of Cardiology
T BartelA C Borges

Abstract

To explain the well known finding of a normal early diastolic filling velocity in advanced grade heart failure due to dilated cardiomyopathy (DCM) exclusively by hemodynamics and to relate Doppler-flow velocity parameters to indices representing pre- and afterload. DCM was hypothesized to be a disorder in which pre- and afterload contribute in equal proportion to cardiac insufficiency independently from ischemic impairment of relaxation. Twenty patients with DCM were enroled in the study after definitive exclusion of coronary and valvular heart disease. Diastolic transmitral and transtricuspid Doppler readings and hemodynamic measurements were done simultaneously by two blinded observers. A Swan-Ganz catheter was employed. Simple and multiple regression analyses revealed early diastolic filling velocity to depend on hemodynamic parameters representing afterload. Pulmonary capillary wedge pressure (PCWP) was found to be directly related to early diastolic filling velocity. An inverse relation between early diastolic filling velocity and parameters representing afterload (systemic vascular resistance and mean arterial pressure) was demonstrated; however the most significant correlation using multiple regression analysis was shown...Continue Reading

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