• Joseph F Polak, Jean M Alessi-Chinetti, Ayan R Patel, and James M Estes.
• Departments of Radiology (J.F.P.) and Vascular Surgery (J.M.A.-C., J.M.E.) and Division of Cardiology/Cardiovascular Center (J.M.A.-C., A.R.P.), Tufts Medical Center, Boston, Massachusetts USA. jpolak@tuftsmedicalcenter.org.
• J Ultrasound Med. 2015 Mar 1; 34 (3): 461-7.

ObjectivesThe appearance of the dicrotic notch on blood pressure tracings is associated with impaired cardiac function. Common carotid artery waveforms have similar fiduciary markers, yet they have not been related to cardiac function. We studied associations of common carotid artery dicrotic notch velocities with the left ventricular ejection fraction (LVEF) determined by echocardiography.MethodsWe conducted a retrospective study of 37 patients who had cardiac echocardiography and carotid Doppler evaluations within 1 day of each other. The LVEF was determined by the biplane modified Simpson rule. Doppler parameters were measured from tracings of the left common carotid artery 4 cm from the flow divider. Linear regression and stepwise multivariable linear regression models were used to evaluate any association between the LVEF and the following variables: age, sex, peak systolic velocity (PSV), end-diastolic velocity (EDV), dicrotic notch velocity, rise time (EDV to PSV), resistive index, and cardiac cycle length.ResultsThe dicrotic notch velocity was the only variable associated with the LVEF (P = .028) in a bivariate analyses. A backward selection stepwise multivariable equation predicting the LVEF had the dicrotic notch (P = .001) and resistive index (P = .01) as significant predictors, whereas the cardiac cycle length (P = .08) and PSV (P = .08) were borderline not significant. Model goodness of fit was R(2) = 0.37 (P = .004).ConclusionsDicrotic notch velocities measured from common carotid artery Doppler waveforms are associated with the LVEF and might offer some clinical value in selected cases.© 2015 by the American Institute of Ultrasound in Medicine.

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