Nagueh et al used Doppler echocardiography to estimate left ventricular filling pressure in a patient with atrial fibrillation (AF). The authors are from Baylor College of Medicine and the Methodist Hospital in Houston.

Patient selection: adults with atrial fibrillation


Goal: detection of patients with left ventricular filling pressure (LVFP) > 15 mm Hg


Factors associated with LVFP:

(1) peak acceleration (PkAcc) of the mitral velocity

(2) isovolumic relaxation time (IVRT)

(3) mean early (E) velocity

(4) ratio of the peak E velocity to M-mode flow propagation velocity

Values determined over 3 cycles were better than values determined using 1 cycle.


Parameters for LVFP prediction equation:

(1) peak acceleration (PkAcc) of the mitral velocity in cm / (seconds squared)

(2) isovolumic relaxation time (IVRT) in milliseconds


predicted left ventricular filling pressure (LVFP) =

= (0.005 * (PkAcc)) - (0.183 * (IVRT)) + 22

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