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Noninvasive evaluation of pulmonary capillary wedge pressure in patients with acute myocardial infarction by deceleration time of pulmonary venous flow velocity in diastole

Atsushi Yamamuro, MD^*, Kiyoshi Yoshida, MD, FACC^*, Takeshi Hozumi, MD^*, Takashi Akasaka, MD^*, Tsutomu Takagi, MD^*, Shuichirou Kaji, MD^*, Takahiro Kawamoto, MD^* and Junichi Yoshikawa, MD, FACC

^* Division of Cardiology, Kobe General Hospital, Kobe, Japan
Osaka City University School of Medicine, Osaka, Japan

View larger version (86K): [in a new window]   Figure 1 Recording of the mitral flow (MF) velocity curve (upper panel) and pulmonary venous flow (PVF) velocity curve (lower panel) in a patient with acute myocardial infarction. Deceleration time of mitral flow velocities in early diastole is measured from peak of early diastolic flow (E) to extrapolation of slope of velocity deceleration to baseline. Deceleration time of pulmonary vein flow velocities in diastole is measured from peak of diastolic forward flow (D) to extrapolation of slope of velocity deceleration to baseline. ECG = electrocardiogram.

View larger version (15K): [in a new window]   Figure 2 Scatterplot of the correlation between mitral deceleration time (LV-DT) and pulmonary capillary wedge pressure (PCWP). The horizontal dashed line marks the value of 130 ms in LV-DT that was found to be the cutoff point in predicting the level of 18 mm Hg in PCWP.

View larger version (14K): [in a new window]   Figure 3 Scatterplot of the correlation between deceleration time of pulmonary venous flow velocities in diastole (PV-DT) and pulmonary capillary wedge pressure (PCWP). The horizontal dashed line marks the value of 160 ms in PV-DT that was found to be the cutoff point in predicting the level of 18 mm Hg in PCWP.

View larger version (14K): [in a new window]   Figure 4 (A) Scatterplot of the correlation between deceleration time of pulmonary venous flow velocities in diastole (PV-DT) and mitral deceleration time (LV-DT) in all patients. (B) Scatterplot of the correlation between PV-DT and LV-DT in patients with a pulmonary capillary wedge pressure (PCWP) of 18 mm Hg. (C) Scatterplot of the correlation between PV-DT and LV-DT in patients with a PCWP of <18 mm Hg.