Abnormal Left Ventricular Diastolic Filling in Chronic Thromboembolic Pulmonary HypertensionTrue Diastolic Dysfunction or Left Ventricular Underfilling?
Swaminatha V. Gurudevan, MD*,
Philip J. Malouf, MD ,
William R. Auger, MD ,
Thomas J. Waltman, MD, FACC,
Michael Madani, MD, FACS ,
Ajit B. Raisinghani, MD,
Anthony N. DeMaria, MD, MACC and
Daniel G. Blanchard, MD, FACC,*
* Division of Cardiology, University of California Irvine School of Medicine, Irvine, California
Cardiology
Pulmonary Medicine
Cardiothoracic Surgery, UCSD Medical Center and University of California, San Diego School of Medicine, San Diego, California
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Figure 1 Example of Transmitral and Pulmonary Venous Doppler Interrogation Before and After Pulmonary Thromboendarterectomy
Transmitral pulsed-wave Doppler interrogation (left) and pulmonary venous Doppler interrogation (right) in a patient with chronic thromboembolic pulmonary hypertension before (above) and after (below) pulmonary thromboendarterectomy.
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Figure 2 Preoperative and Postoperative Parameters in Patients Undergoing PTE
The p values are significant for all comparisons between preoperative and postoperative parameters except Em (septal). All variables are presented as mean ± standard deviation. Solid bars = postoperative; open bars = preoperative. A = A velocity; CTEPH = chronic thromboembolic pulmonary hypertension; D = diastolic pulmonary venous flow velocity; E = E velocity; Em = early mitral annular tissue Doppler velocity; PTE = pulmonary thromboendarterectomy; S = systolic pulmonary venous flow velocity.
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Figure 3 Comparison of E and PVR in Patients With CTEPH Undergoing PTE
Solid circles = preoperative patients; open circles = postoperative patients. Logarithmic regression analysis with 95% confidence intervals is also shown. PVR = pulmonary vascular resistance; other abbreviations as in Figure 2.
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