The Evaluation of Pulmonary Venous Flow by Transesophageal Pulsed Doppler Echocardiography in Patients with Rheumatic Mitral Stenosis

The aim of this study was to evaluate the pulmonary venous (PV) flow by transesophageal pulsed Doppler echocardiograpy in 14 patients with rheumatic mitral stenosis (MS) in sinus rhythm and 5 healthy subjects. PV flow was detected by transesophageal echocardiography and velocity-time integral was determined. Pulmonary capillary wedge (PCW) pressure of 16 patients was measured with cardiac catheterization and of 5 patients with SwanGanz technique peroperatively. PCW pressure was 25±6 mmHg in MS group and 6±1 mmHg in control group (p<0.0001). PV systolic flow rate was 41±15 cm/sec in MS group and 61±22 cm/sec in control group (p<0.05). PV diastolic flow rate was 48±17 cm/sec in MS group and 27±16 cm/sec in control group (p<0.02). PV late systolic flow rate ( -A wave) was 23±8 cm/sec in MS group and 21±5 cm/sec in control group (p: ns). PV systolic, diastolic and Iate diastolic velocity-time integral values were (5.8±2.6), (7.4±3), (2.3±0.8) cm in MS group and (9.4±4.3), (4.6±1.9), (2±1) cm in control group respectively. There were no significant differences between the two groups. PV systolic flow / PV diastolic flow value was <1 in MS group ant >1 in control group. Hence, in MS group with high left atrial pressuie PV systolic flow rate was significantly lower and PV diastolic pressure was significantly higher than the control group. Systolic velocity-time integral value and PV Iate diastolic flow was slightly higher in the MS group but it was not significant. Diastolic velocity-time integral value was lower in the MS group but it was also not significant.