LV dP/dt from the MR jet

dP/dt · CW Doppler of the MR jet at 100 mm/s: time between 1 and 3 m/s; dP/dt = 32 mmHg / Δt

Normal range & thresholds

>1200 mmHg/s normal · <800 markedly reduced. In chronic heart failure, dP/dt <600 mmHg/s identified the highest mortality risk ^[118]. −dP/dt (relaxation) is taken from the downslope.

Pathophysiology

During isovolumic contraction the LV–LA gradient rises as fast as the ventricle generates pressure. The MR jet samples that rise without an invasive catheter: 4(3²−1²) = 32 mmHg over the measured interval ^[118].

Raised by

• Inotropes, hyperdynamic states

Lowered by

• Systolic dysfunction; also falls with lower preload

Technique & pitfalls

• Requires a clear early MR envelope; fast sweep; align CW with the jet.

Pseudo-change & artefact

• Eccentric jets and poor early envelopes; very high LA pressure reduces the gradient.

Treatment thresholds

No guideline threshold; prognostic in HF and useful for contractile reserve.

Next step

• EF, GLS and myocardial work for a fuller picture.

Drugs

Inotropes raise; β-blockers lower acutely.

Reversibility

Tracks contractile recovery.