A Novel Noninvasive Method to Assess Left Ventricular -dP/dt Using Diastolic Blood Pressure and Isovolumic Relaxation Time

作者：Parekh Rupal^*; Kolias Theodore J

来源：Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques, 2013, 30(3): 267-270.

DOI：10.1111/echo.12042

• echocardiography
• Doppler echocardiography
• diastolic function

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 (32mmHg/time from 3 to 1m/sec). dP/dt was also determined using the DBP-IVRT method using the following equation: dP/dt=(DBPLVEDP)/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 +/- 201mmHg by the Doppler-MR method and 681 +/- 237mmHg 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 BlandAltman 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.

• 出版日期2013-3