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ECHONOMY
Tools for Echocardiographic Calculations
Muhamed Saric, MD, PhD
New York University
 

LVEDP by ARW

Purpose
To estimate left ventricular end-diastolic pressure (LVEDP) by comparing the duration of the mitral inflow A wave and the duration of the atrial reversal wave (ARW) in the pulmonary vein.

Technical Hints
Used pulsed wave Doppler sampling at the mitral leaflet tips and in the pulmonary vein 1 cm proximal to the pulmonary vein-left atrial junction.

Calculator

Mitral inflow A wave duration:

 msec

Pulmonary vein ARW duration:

 msec

  


 		  

Answers

Difference in duration:

 msec
     

Interpretation

ARW - A wave
(msec)

 LVEDP
(descriptive)		 LVEDP
(mm Hg)		  
ARW lasts longer than A Elevated > 15  
> 30 Separates amyloidosis from normals.  
 

Formula

Difference in duration = ARW duration - A wave duration
 

Reference
Rossvoll O, Hatle LK. Pulmonary venous flow velocities recorded by transthoracic Doppler ultrasound: relation to left ventricular diastolic pressures. J Am Coll Cardiol 1993;21:1687-96.

Abdalla I, Murray RD, Lee JC, et al. Duration of pulmonary venous atrial reversal flow velocity and mitral inflow a wave: new measure of severity of cardiac amyloidosis. J Am Soc Echocardiogr 1998;11(12):1125–1133.