Abnormalities of left ventricular filling in valvular aortic stenosis. Usefulness of combined evaluation of pulmonary veins and mitral flow by means of transthoracic Doppler echocardiography.

It has been recently demonstrated that indexes obtained from the study of pulmonary venous flow by Doppler echocardiography are related to left ventricular (LV) pressures during diastole and may improve the assessment of LV filling derived from analysis of mitral flow velocities. In this study we evaluated the pattern of pulmonary venous flow and transmitral flow by means of transthoracic pulsed Doppler echocardiography in 31 adult patients (11 females, 20 males, mean age 72 +/- 10 years) with valvular aortic stenosis (Doppler valve area: 0.77 +/- 0.17 cm2) and in 15 age-matched normal subjects (five females, 10 males, mean age 68 +/- 6 years). Doppler indexes of mitral flow were similar between the two groups; on pulmonary venous flow, peak systolic velocity was lower (46 +/- 13 vs. 63 +/- 17 cm/s, P < 0.01) and both duration of reversal flow during atrial systole and difference between pulmonary atrial reversal flow and mitral A wave duration were longer in aortic stenosis patients compared to normals (148 +/- 21 vs. 111 +/- 16 ms and 6 +/- 27 vs. -26 +/- 21 ms, respectively, P < 0.001). Twenty-two aortic stenosis patients showed an early to late mitral flow ratio (E/A) < or = 1 and the remaining nine patients had a E/A > 1.(ABSTRACT TRUNCATED AT 250 WORDS)