Relation of Left Ventricular Filling Paterns to The Ratio of Pulmonary Venous to Mitral A Velocity in Patients with Left Ventricular Systolic Dysfunction

Abstract

Objective:  In the present study, we retrospectively
evaluated the ratio of pulmonary venous to mitral A
velocity (PV-A/A) in patients with left ventricular (LV)
systolic dysfunction with three specific types of LV
filling patterns.
Method:Transthoracic and transesophageal
echocardiography were performed in 44 patients with
LV systolic dysfunction in sinus rhythm, aged 20 to 73
years (mean 54±12), and in 11 control subjects without
cardiovascular disease aged 24 to 69 years (mean
53±7). Patients were divided into three groups
according to LV filling pattern: Group I; those with an
impaired relaxation filling pattern (E wave/A wave <1,
n=16), group II; those with a pseudonormal filling
pattern (1<  E/A<2 , n=12) and group III; those with a
restrictive filling pattern (E/A> 2, n=16).
Results: The control group and the three patient groups
were not different with respect to age, gender and heart
rate. All patient groups showed significantly lower LV
ejection fraction than the control group, and was lowest
in group III.  The mitral peak A wave velocity was
significantly lower in group III than in the first, control
and second groups (p<0.001, p<0.01and p<0.05,
respectively) and was highest in group I. The
pulmonary A wave velocity did not differ among groups
I, III and the controls, and was higher in group II than
in the controls (p<0.01). The PV-A/A ratio was
significantly higher in group III than in the control,
groups I and II (p<0.001, p<0.001and p<0.05,
respectively). The ratio did not differ between the
controls and group I, but were lower compared to the
group II (p<0.05).
Conclusion: An increased ratio of PV-A/A was noted
in subjects with LV systolic dysfunction with restrictive
and pseudonormal  LV filling patterns. This supports
the idea that the PV-A/A ratio reflects LV filling
pressures.
Key words: Ventricular filling patern to mitral A velocity,
ventricular systolic dysfunction

Keywords

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