The relationship of pulmonary artery wedge pressure to the posterior aortic wall echocardiogram in patients free of obstructive mitral valve disease.

Aortic wall echocardiograms were obtained simultaneously with pulmonary artery wedge pressures (PAWP) in 21 patients free of obstructive mitral valve disease. There was a significant (p < 0.001) negative correlation between the fraction of passive posterior aortic wall motion occurring in the first third of diastole (the atrial emptying index--AEI) and the pulmonary artery wedge pressure (r = -0.91). The AEI for patients with normal PAWP (less than or equal to 12 mm. Hg) was 0.94 +/- 0.06 (mean +/- S.D.) compared with 0.61 +/- 0.20 for those with abnormal PAWP (> 12 mm. Hg). No patient with a normal PAWP had an AEI < 0.80, and no patient with a PAWP > 18 mm. Hg had an AEI > 0.66. These data suggest that analogous to the reported use of the AEI to estimate severity of mitral obstruction, the index provides a noninvasive measure of left ventricular filling pressure when the mitral valve is normal.