Doppler echocardiographic analysis of flow velocity patterns of systemic and pulmonary veins in various heart diseases

To evaluate the venous flow dynamics in systemic and plumonary veins, we analyzed Doppler flow signals in superior vena cava (SVCF) and left upper plumonary veins (PVF : by transesophageal echo) in 14 normal subjects c and 26 patients including 10 with anterior myocardial infardtion (AMI), 8 with inferior myocardial infarction (IMI), and 8 with hypertrophic cardio cardiomyopathy (HCM). In all subjects biphasic systolic forward flow was recognized (S1, S2). The timing of S1 showed rough correlation between SVCF and PVF (r＝0.50, p＜0.01). In each group, peak velocities of S1 and S2 in PVF were larger than thosein SVCF and peak velocity ratio (pV-S1/S2) of PVF was significantly higher than that in SVCF except IMI group. The time-integral ratio of S1 to total systolic flow in PVF was also larger than that in SVCF. These results indicated that the contribution of S1 to atrial reservioir function was larger in PVF than that in SVCF. In IMI, both peal velocity ratio and time-integral ratio in PVF were higher than in C group, suggesting that increased S1 weve was probably due to augmented left atrial contraction and relaxation resulted from severe impairment of left ventricular diastolic property. This tendency was also seen in SVCF, suggesting that severe damage of ventricular septum and pericardial effect might affect right ventricular diastoloc performance, and hyperkinetic motion of interatrial septum might enlarge S1 of SVCF. Acceleration rate (ACR) od S1 wave in PVF showed rough correlation with left ventricular end-diastoloc pressure (LVEDP, r＝0.54, p＜0.01) in patients except HCM group. In HCM group as well as AMI group, it was recoginized that increased peal A wave velocity, increased LVEDP and augmentation of S1 contribution to left atrial reservoir function. But, was significantly decreased in HCM group, suggesting impairment of left artial relaxation itself. This tendency was also seen in SVCF. Venous flow pattern obtained by Doppler echocardiography would enable us to evaluate both of atrial function.