Abstract
Adult studies indicate a strong correlation between PA wedge pressure (WEDGE) and the RATIO and difference (DIFF) of 2 echo-cardiographic (ECHO) mitral valve diastolic time intervals: Q-mitral valve closure (Q-MVC) and aortic valve closure-mitral E point (AVC-E). Effects of HR on these intervals and of respiratory phase on WEDGE were not considered.
We measured one ECHO-WEDGE data set from each of 24 young patients during routine cardiac catheterization. Mean age was 4.7 yrs (range 0.3-15,8). None had prolonged PR, mitral stenosis, or were intubated. WEDGE ranged from 4-22 mm Hg (mean 10.1). ECHO intervals were measured at end-inspiration and end-expiration and arithmetically adjusted for HR differences within and between patients. No significant correlation coefficient was found between WEDGE and RATIO or DIFF, regardless of RR adjustment or respiratory phase (-0.2<r<0.2, p>.05 for each).
Multiple data sets were then obtained from 6 neonatal piglets whose LVEDP was increased from 3-38 mm Hg by volume infusion. Again, no correlation between LVEDP and any derived ECHO function was large enough for predictive purposes (r≤.40 by linear regression analysis).
No significant relationship was found between ECHO and WEDGE measurements in small subjects, unlike in adults. Confirmation studies are needed in adults.
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Schieber, R., Braum, P. & Neches, W. 137 ECHOCARDIOGRAPHY DOES NOT ACCURATELY PREDICT PA WEDGE FISSURES IN SMALL SUBJECTS. Pediatr Res 19, 133 (1985). https://doi.org/10.1203/00006450-198504000-00167
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DOI: https://doi.org/10.1203/00006450-198504000-00167