title: Noninvasive differentiation of normal from pseudonormal/restrictive mitral flow using TEI index combining systolic and diastolic function.
abstract: Differentiation of normal from pseudonorma/restrictive mitral flow is not necessarily easy. Pseudonormal/restrictive flow is usually associated with left ventricular (LV) dysfunction, which can be detected using the TEI index, combining systolic and diastolic function. The purpose of this study was to test the feasibility of using the TEI index to differentiate pseudonormal/restrictive from normal mitral flow. In 33 patients with mitral flow E/A > or = 1 and LV mid-diastolic pressure measured by catheterization, the LV volumes, mitral E and A velocity, deceleration time of the E velocity, and the TEI index, defined as the sum of the isovolumic contraction and relaxation time divided by ejection time, were evaluated using Doppler echocardiography. Pseudonormal/restrictive mitral flow was defined as mitral flow E/A > or = 1 associated with LV mid-diastolic pressure > 12 mmHg. There were 22 and 11 patients with normal and pseudonorma/restrictive mitral flow, respectively. Among the indices of LV function, the TEI index achieved the best correlation with LV mid-diastolic pressures (r2 = 0.63, p < 0.0001). By setting the TEI index > or = 0.65 as the criteria for pseudonormal/restrictive mitral flow, this diagnosis had sensitivity, specificity, and accuracy of 82%, 96%, and 91%, respectively. TEI index allows noninvasive differentiation of pseudonormal /restrictive from normal mitral flow.
authors.affiliation: First Department of Internal Medicine, Kagoshima University School of Medicine, Japan.
authors.forename: Hui
authors.initials: H
authors.lastname: Zhang
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Otsuji
authors.forename: Keiko
authors.initials: K
authors.lastname: Matsukida
authors.forename: Shuichi
authors.initials: S
authors.lastname: Hamasaki
authors.forename: Shiro
authors.initials: S
authors.lastname: Yoshifuku
authors.forename: Toshiro
authors.initials: T
authors.lastname: Kumanohoso
authors.forename: Chihaya
authors.initials: C
authors.lastname: Koriyama
authors.forename: Akira
authors.initials: A
authors.lastname: Kisanuki
authors.forename: Shinichi
authors.initials: S
authors.lastname: Minagoe
authors.forename: Chuwa
authors.initials: C
authors.lastname: Tei
mesh_terms: D000368:Aged; D001783:Blood Flow Velocity; D006328:Cardiac Catheterization; D003971:Diastole / Q000502:physiology; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000503:physiopathology*; D015588:Observer Variation; D011446:Prospective Studies; D015203:Reproducibility of Results; D013599:Systole / Q000502:physiology; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000503:physiopathology