Prognostic value of pulmonary venous flow Doppler signal in left ventricular dysfunction
contribution of the difference in duration of pulmonary venous and mitral flow at atrial contraction
Frank Lloyd Dini, MD*,
Claudio Michelassi ,
Giovanni Micheli, MD* and
Daniele Rovai, MD, FESC
* Unità Operativa di Cardiologia, Villamarina Hospital, Piombino, Italy
CNR, Clinical Physiology Institute, Pisa, Italy
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Figure 1 Pulsed Doppler mitral flow velocity (left panel) and contrast-enhanced pulmonary venous flow velocity (right panel) in a patient with LV systolic dysfunction. Mitral A-wave duration (measured from the start of flow until flow ceases) was 125 ms. Pulmonary vein atrial reversal duration (from onset to the cessation of reversed flow) was 175 ms. The difference was 50 ms. Assessment of pulmonary venous flow variables was accomplished after venous contrast administration.
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Figure 2 Bar graph showing the sensitivity (solid bars) and the specificity (open bars) of restrictive mitral flow pattern (panel A), of ARd-Ad  30 ms (panel B) and E/A >1 (panel C) in predicting clinical events.
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Figure 3 Twenty-four-month estimates of survival and event rates after index Doppler echocardiogram by Kaplan-Meier analysis. Groups were stratified according to restrictive mitral flow (group 1), nonrestrictive mitral flow with a ARd-Ad 30 ms (group 2) and nonrestrictive mitral flow with ARd-Ad <30 ms (group 3). (A) Rates of survival free from cardiac mortality. (B) Rates of cardiac event-free survival. (C) Rates of freedom from heart failure.
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