Ductus venosus wave form assessment methods Indices Method Consecutive cardiac event Pulsatility index Reflects deterioration in forward for vein cardiac function Systolic velocity Semi quantitative Cannot identify which component of - End diastolic forward cardiac function was velocity deteriorated (preload, contractility/compliance or afterload) Time average maximum velocity A-wave assessment Visual Impaired atrial contraction Velocity ratios S/v Forward flow into atria during end-systole v/D Ventricular relaxation D/a Ratio Passive and active diastolic filling S/D Ventricular systole and early diastolic filling S/a Ventricular systole and late diastole
(active filling) v/a End-systole and late diastole
Retrospective reconstruction of the image data was performed for acquisition of phase images starting from early systole (10% of the R-R interval) and ending at late diastole
(90% of the R-R interval) using 10% increments.
In the apical 4-chamber view, the Doppler sample volume was placed in the middle of LV inflow tract 1 cm below the plane of mitral annulus between the mitral leaflet tips, where maximal flow velocity in early and late diastole
Left atrium (LA) is a reservoir for the LV during systole, a conduit [for blood to ow from pulmonary veins (PVs) to the LV] during early diastole and an active contractile chamber in late diastole
. It contributes up to 30% of LV output.
Myocardial velocities were measured in systole (Sm), early diastole (Em) and late diastole
(Am) and the Em/Am ratio was calculated.
The apical four-chamber view was obtained for diastolic function analysis which included measurement of peak mitral inflow velocity at early diastole and at late diastole
. Left ventricular inflow signals were obtained in the pulse mode by placing the sample volume between the mitral leaflets and adjusting the position until the highest peaks of diastolic velocity were obtained.
Studies have demonstrated that the peak velocity in late diastole
secondary to atrial contraction (A7) measured using pulsed wave DTI is a rapid and an accurate marker of atrial function [29, 30].
The peak velocity of blood flow during early diastole (called the "E wave") and late diastole
(the atrial contraction, or "A wave") is measured and the E/A ratio (reflecting the transmitral blood flow pattern) is calculated (FIGURE).
Restrictive physiology is defined as antegrade blood flow to the pulmonary artery during late diastole
. It has been proposed that this physiology protects against RV dilation after total correction of ToF (9-14).
At S0, PW-TDI graphics provided one positive systolic wave (Sa), and two negative diastolic waves (Ea and Aa, respectively, in early and late diastole
; Figure 1A).
Dip and plateau (or square root) configuration of ventricular pressures reflects a rapid early diastolic filling of the ventricles, followed by lack of additional filling during late diastole
The scans are triggered by EKG (electrocardiogram) during late diastole
, with a breath hold.