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

PAWP by E/Vp

Purpose
To estimate pulmonary artery wedge pressure (PAWP) from two different mitral blood velocities: peak E wave velocity by pulsed Doppler, and flow propagation velocity (Vp) by color M mode.

Technical Hints
For Vp, place color box over zoomed LV in the apical 4-chamber view. Place the Doppler cursor along the mitral inflow. Turn on the color; set the Nyquist limit to about 40-50 cm/sec. Measure the acceleration slope of the early diastolic flow.

Calculator

Peak mitral inflow E velocity:

 cm/sec

Flow propagation velocity (Vp):

 cm/sec

  
(Normal Vp: > 55 in young; >45 in old people)  


 		  

Answers

E/Vp ratio:

 
     

Mean PAWP

 mm Hg
     

Interpretation

E/Vp' Ratio

 Mean PAWP
(descriptive)		 Mean PAWP
(mm Hg)		  
 > 1.4 Elevated > 12  
 
 

Formula

PAWP = 4.6 + 5.27 * E/Vp
 

Reference
Garcia MJ, Ares MA, Asher C, Rodriguez L, Vandervoort P, Thomas JD. An index of early left ventricular filling that combined with pulsed Doppler peak E velocity may estimate capillary wedge pressure. J Am Coll Cardiol 1997;29:448-54