Effect of positive end-expiratory pressure on left and right ventricular diastolic filling assessed by transoesophageal Doppler echocardiography

Takashige Yamada, J. Takeda, M. Satoh, K. Koyama, Saori Hashiguchi, M. Yokoi

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

The effect of positive end-expiratory pressure (PEEP) on left and right ventricular diastolic filling dynamics was assessed by transmitral and transtricuspid flow patterns. Using transoesophageal Doppler echocardiography in fourteen ASA physical status 1 female patients, the following measurements were performed at baseline (0 cmH2O PEEP) and at 5, 10, 15, and 20 cmH2O PEEP: 1. peak velocity of early filling (peak E velocity), 2. peak velocity of atrial contraction (peak A velocity), 3. the ratio of the peak E to A velocity (peak E/A velocity ratio), 4. isovolumic relaxation time (IRT), 5. acceleration half-time (AHT), 6. deceleration half-time (DHT) of early filling, and 7. end-diastolic and end-systolic areas of both ventricles. Increasing PEEP progressively deceased peak E velocity of both ventricles. In contrast, peak A velocity did not change and the peak E/A velocity ratio decreased significantly with PEEP. IRT and AHTs remained unchanged, but DHTs of both ventricles increased following PEEP. End-diastolic and end-systolic areas of both ventricles decreased gradually and significantly with PEEP. It is concluded that PEEP was associated with decreased preload as well as reduced compliance of both ventricles, which was considered to contribute to the changes in diastolic ventricular filling.

Original languageEnglish
Pages (from-to)341-345
Number of pages5
JournalAnaesthesia and Intensive Care
Volume27
Issue number4
Publication statusPublished - 1999 Aug

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Positive-Pressure Respiration
Doppler Echocardiography
Transesophageal Echocardiography
Deceleration
Compliance

Keywords

  • Heart: echocardiography, transoesophageal Doppler, diastolic ventricular filling
  • Ventilation: positive end-expiratory pressure (PEEP)

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Effect of positive end-expiratory pressure on left and right ventricular diastolic filling assessed by transoesophageal Doppler echocardiography. / Yamada, Takashige; Takeda, J.; Satoh, M.; Koyama, K.; Hashiguchi, Saori; Yokoi, M.

In: Anaesthesia and Intensive Care, Vol. 27, No. 4, 08.1999, p. 341-345.

Research output: Contribution to journalArticle

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AU - Hashiguchi, Saori

AU - Yokoi, M.

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AB - The effect of positive end-expiratory pressure (PEEP) on left and right ventricular diastolic filling dynamics was assessed by transmitral and transtricuspid flow patterns. Using transoesophageal Doppler echocardiography in fourteen ASA physical status 1 female patients, the following measurements were performed at baseline (0 cmH2O PEEP) and at 5, 10, 15, and 20 cmH2O PEEP: 1. peak velocity of early filling (peak E velocity), 2. peak velocity of atrial contraction (peak A velocity), 3. the ratio of the peak E to A velocity (peak E/A velocity ratio), 4. isovolumic relaxation time (IRT), 5. acceleration half-time (AHT), 6. deceleration half-time (DHT) of early filling, and 7. end-diastolic and end-systolic areas of both ventricles. Increasing PEEP progressively deceased peak E velocity of both ventricles. In contrast, peak A velocity did not change and the peak E/A velocity ratio decreased significantly with PEEP. IRT and AHTs remained unchanged, but DHTs of both ventricles increased following PEEP. End-diastolic and end-systolic areas of both ventricles decreased gradually and significantly with PEEP. It is concluded that PEEP was associated with decreased preload as well as reduced compliance of both ventricles, which was considered to contribute to the changes in diastolic ventricular filling.

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