Relation Between Capillary Wedge Pressure Measured by Echocardiography Through Tissue Doppler Imaging (TDI) Method and Catheterism in Patients with Mitral Valve Stenosis

Abstract

Background: Considering suggested formula in the references and PCWP measured by catheterism, in the present study the relation between pulmonary capillary wedge pressure (PCWP) measured the flow velocity of mitral valve and mitral annulus motion through tissue doppler imaging is evaluated

Methods: 52 cases of severe MS were admitted for Balloon Mitral Valvolotomy (BMV) are included in this study. Mean age was 35±5 years consisting of 40 females and 12 males.   Valve area, Pulmonary artery systolic pressure (PAP), E (Maximum Velocity of mitral valve at the beginning of diastole) & Em (Maximum rate of mitral annular motion at the beginning of diastole which is recorded through septal or lateral wall annulus site) velocity and left atrial (LA) size were also measured by echocardiography and  PCWP & PAP through catheterism. All patients had normal ejection fraction (EF) and coronary arteries; there was no other valvular diseases and shunts.

Results: There was a significant correlation between PAP in echocardiography and catheterism. Mean PAP was 53±19 mmHg in echocardiography and 53.9±17.8mmHg in catheterism. There wasn't any correlation between PCWP in echocardiography and catheterism (P=0.33) and also no relation between PCWP and mitral valve area (MVA) or LA size (P=0.2). E/Em ratio increased in severe MS cases.

Conclusion: E/Em ratio and suggested formula would overestimate the wedge pressure so echocardiography is not a reliable method for measuring PCWP in severe MS. Em velocity and E/Em ratio may be used for estimating MS severity.