Effects of lower body negative pressure and volume loading on transmitral flow velocity pattern by pulsed doppler echocardiography.

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Abstract
The transmitral flow (TMF) profile was studied in 18 patients with ischemic heart disease and in 4 patients with chest pain syndrome in order to clarify the dependency of preload alteration on the pattern of TMF. Pulsed Doppler echocardiography with simultaneous measurement of right-sided cardiac catheterization and M-mode echocardiography during lower body negative pressures (LBNP 01, -10 mmHg, -20 mmHg) and Dextran infusions (Dex 100 ml, 200 ml) were used in the study. After LBNP, peak velocities in rapid filling (peak R) (cm/sec) decreased (control; 68.3 .+-. 13.9, LBNP-10 mmHg; 59.8 .+-. 15.2, p < 0.01, LBNP-20 mmHg; 55.2 .+-. 11.0, p < 0.01) and the integrals in the first half phase in rapid filling (IR1) (cm) also decreased (control; 4.0 .+-. 0.8, LBNP-10 mmHg; 3.4 .+-. 0.9, LBNP-20 mmHg; 3.2 .+-. 0.9, p < 0.05). During Dextran infusion, peak R (cm/sec) increased (control; 53.5 .+-. 7.5, Dex 100 ml; 57.8 .+-. 10.0, p < 0.05, Dex 200 ml; 60.4 .+-. 10.6, p < 0.01) as did IR1 (cm) (control; 3.2 .+-. 1.1, Dex 100 ml; 3.8 .+-. 1.0, p < 0.01, Dex 200 ml; 4.2 .+-. 1.3, p < 0.01). In conclusion, changes in preload may alter the peak velocity and the first half integral in left ventricular rapid filling depending on the pattern of transmitral flow velocity.

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