Evaluation of M-mode echographic estimates of left ventricle function: relationship of selected ultrasonic and hemodynamic parameters.

We examined the relationship between echocardiographic and hemodynamic parameters in 48 patients with left ventricular ejection fractions less than 50% without primary valvular disease. Pulmonary wedge pressure (PWP) correlated with the PR-AC interval (r = -0.62) and with left atrial dimension (r = 0.64) but not with left ventricular diastolic dimension. A PR-AC interval less than or equal to 60 msec was observed in 26 of 29 (90%) patients with a PWP greater than or equal to 14 mm Hg versus 1 of 10 (10%) patients with a PWP less than 14 mm Hg. The correlation between PWP and the PR-AC interval was substantially better in patients with a PR interval less than or equal to 200 msec (r = -0.79) than in patients with a PR interval greater than 200 msec (r = -0.55). The PR-AC interval also correlated with the ejection fraction (r = 0.47). A left atrial dimension greater than or equal to 4.0 cm was observed in 29 of 35 (83%) patients with a PWP greater than or equal to 14 mm Hg versus 0 of 9 (0%) patients with a PWP less than 14 mm Hg. Stroke volume (SV) correlated with aortic root excursion (r = 0.71) and with SV calculated from formulas based on mitral valve motion (r = 0.76) or aortic valve motion (r = 0.62). However, no echo formula provided valid estimates of cardiac output. We conclude that M-mode echocardiography provides a relatively useful noninvasive method of assessing left ventricular filling pressure in patients with reduced ejection fraction and no valvular disease.