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. 2001 Jan;85(1):23–29. doi: 10.1136/heart.85.1.23

Pulmonary venous flow velocity patterns in 404 individuals without cardiovascular disease

S F de Marchi 1, M Bodenmuller 1, D Lai 1, C Seiler 1
PMCID: PMC1729579  PMID: 11119456

Abstract

OBJECTIVE—To determine the pulmonary venous flow velocity (PVFV) values in a large normal population.
DESIGN—Prospective study in consecutive individuals.
SETTING—University hospital.
METHODS—Among 404 normal individuals, the flow velocity pattern in the right upper pulmonary vein was recorded in 315 subjects using transthoracic echocardiography, and in both upper pulmonary veins in 100 subjects using transoesophageal echocardiography. Subjects were divided into five age groups. The PVFV values were compared between transthoracic and transoesophageal echocardiography within the age groups, and intraindividually between the right and left upper pulmonary veins in transoesophageal echocardiography.
RESULTS—Normal PVFV values for the right upper pulmonary vein in transthoracic and transoesophageal echocardiography are presented. The duration of flow reversal at atrial contraction was overestimated using transthoracic echocardiography (mean (SD): 96 (21) ms in transoesophageal echocardiography, 120 (28) ms in transthoracic echocardiography, p < 0.0001). Systolic to diastolic peak flow velocity ratio (S:D) increased earlier with advancing age with transoesophageal echocardiography than with transthoracic echocardiography. Similar results were found for the corresponding time-velocity integrals. Data from the left and right upper pulmonary veins differed with respect to onset and deceleration of flow velocities, but not for flow durations or peak velocities.
CONCLUSIONS—Normal PVFV values generally show a wide range. The data presented will be of value in assessing left ventricular diastolic function and mitral regurgitation using the PVFV pattern.


Keywords: pulmonary venous flow velocity; Doppler echocardiography; mitral regurgitation

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Figure 1  .

Figure 1  

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(A) Transoesophageal Doppler echocardiographic recording of right upper pulmonary venous flow in a 67 year old man. (B) Illustration of the flow velocity variables measured in each pulmonary vein. Explanations of abbreviations are given in the box.

Figure 2  .

Figure 2  

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(A) Correlation between first and second observers' velocity measurements (systolic, diastolic, and reversed flow at atrial contraction) in transthoracic and transoesophageal echocardiography. (B) Bland-Altmann plot showing the interobserver variability of pulmonary venous flow velocity measurements in transthoracic and transoesophageal echocardiography. The solid line indicates the mean and the dashed lines the 95% confidence intervals of the interobserver difference of all flow velocity measurements. LUPV, left upper pulmonary vein; RUPV, right upper pulmonary vein; TOE, transoesophageal echocardiography; TTE, transthoracic echocardiography.

Figure 3  .

Figure 3  

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Relation between age and the systolic to diastolic peak flow velocity ratio (S:D). There was a significant increase in S:D with advancing age in both transthoracic and transoesophageal echocardiography. However, this increase was less pronounced in transthoracic echocardiography. The dotted arrows indicate the age at which the regression lines exceed S:D = 1 (that is, 41 years in transthoracic and 32 years in transoesophageal echocardiography). Note that there is an abundant scatter of normal S:D values in all age groups. LUPV, left upper pulmonary vein; RUPV, right upper pulmonary vein; TOE, transoesophageal echocardiography; TTE, transthoracic echocardiography.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

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