Does rapid volume loading during transesophageal echocardiography differentiate XXXX from @entity296 ?

@entity1 @entity296 @entity3822 @entity67 @entity15496
BACKGROUND: Respiratory variation of the pulmonary venous (PV) peak flow velocities can be used to distinguish @entity3822 ( @entity15496 ) from @entity296 (restriction). Rapid volume expansion has been used successfully to enhance diastolic pressure equalization in occult @entity15496 . The effect of volume on the respiratory variation in @entity15496 has not been studied previously. This study assessed the utility of volume in enhancing the PV respiratory variation of @entity15496 to further separate it from restriction. METHODS: The study population consisted of 15 @entity1 referred to the echocardiography laboratory for further evaluation of clinically suspected @entity67 . Pulsed-Doppler transesophageal echocardiography (TEE) of the left or right upper pulmonary vein and mitral inflow was performed with respiratory monitoring before and after infusion of 1 liter of normal saline over 5 to 10 minutes. The classification of @entity1 as @entity15496 (n = 8) or restriction (n = 7) was confirmed independently by cardiac catheterization or surgery. Peak velocities of the PV systolic and diastolic waves and the mitral inflow E were measured during inspiration and expiration. A mean of 3-6 respiratory cycles was obtained for each value before and after volume loading. The percent change from expiration to inspiration (%E) was calculated using the formula %E = expiration - inspiration / expiration. RESULTS: At baseline, @entity1 with @entity3822 can be separated reliably from those with @entity296 based on a higher systolic/diastolic ratio and greater respiratory variation of their PV diastolic flow velocity. There were no complications in any @entity1 due to volume expansion. Although the change from baseline to volume expansion was not statistically significant in either @entity15496 or restriction, the %E of the PV diastolic wave became significantly higher in @entity15496 than in restriction (P < 0.05). CONCLUSIONS: Rapid volume expansion is relatively safe during TEE and can be used for further separation of @entity3822 from @entity296 by significantly enhancing the respiratory variation of the PV diastolic flow velocity in @entity3822 .
