title: Mitral annular descent velocity by tissue Doppler echocardiography as an index of global left ventricular function.
abstract: Mitral annular descent has been described as an index of left ventricular (LV) systolic function, which is independent of endocardial definition. Echocardiographic tissue Doppler imaging is a new technique that calculates and displays color-coded cardiac tissue velocities on-line. To evaluate mitral annular descent velocity as a rapid index of global LV function, we performed tissue Doppler imaging studies in 55 patients, aged 56 +/-15 years, within 3 hours of radionuclide ventriculographic ejection fraction. Tissue Doppler M-mode studies were obtained from each of 6 mitral annular sites, as follows: inferoseptal and lateral from apical 4-chamber views, anterior and inferior from apical 2-chamber views, and anteroseptal and posterior from apical long-axis views. Only 1 patient with severe mitral annular calcification was excluded. The group mean 6-site average peak mitral annular descent velocity was 5.5 +/- 1.9 cm/s (range 2.4 to 10.5), and the group mean ejection fraction was 49 +/- 18% (range 17 to 80%). The 6-site average peak annular descent velocity correlated linearly with LV ejection fraction (r = 0.86, SEE = 1.02 cm/s): LV ejection fraction = 8.2 (average peak mitral annular descent velocity) + 3%. The 6-site peak mitral annular descent velocity average >5.4 cm/s was 88% sensitive and 97% specific for ejection fraction >50%. The peak mitral annular descent velocity from the apical 4-chamber view (average from inferoseptal and lateral sites) correlated most closely with the LV ejection fraction (r = 0.85) as an individual view. Peak mitral annular descent velocity by tissue Doppler imaging has the potential to estimate rapidly the global LV function.
authors.affiliation: Division of Cardiology, University of Pittsburgh, Pennsylvania 15213, USA.
authors.forename: V K
authors.initials: VK
authors.lastname: Gulati
authors.forename: W E
authors.initials: WE
authors.lastname: Katz
authors.forename: W P
authors.initials: WP
authors.lastname: Follansbee
authors.forename: J
authors.initials: J
authors.lastname: Gorcsan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D006331:Heart Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000503:physiopathology*; D009200:Myocardial Contraction; D015635:Radionuclide Ventriculography; D012680:Sensitivity and Specificity; D013318:Stroke Volume; D016277:Ventricular Function, Left