Comparison of early diastolic mitral annular velocity and flow propagation velocity in detection of mild to moderate left ventricular diastolic dysfunction.
BACKGROUND
Pulsed wave tissue Doppler echocardiography (PW-TDE) and color M-mode are new Doppler methods for left ventricular (LV) diastolic function assessment. To date, few studies have compared the data obtained by these methods in the same series of patients and compared them to the current clinical reference method of detecting LV diastolic function.


OBJECTIVE
To determine the utility of PW-TDE and color M-mode parameters in the assessment of LV diastolic function in the typical patient population encountered in daily clinical practice and to compare their discriminating power.


METHODS
Early diastolic septal mitral annular velocity (Em) determined by PW-TDE and color M-mode flow propagation velocity (Vp) were measured in 86 male patients and compared to LV filling patterns obtained using standard Doppler indices. Values of Em < 0.08 m s(-1) and Vp < 0.5 m s(-1) were considered as markers of abnormal LV diastolic function.


RESULTS
A value of Em < 0.08 m s(-1) distinguished mild to moderate LV diastolic dysfunction with higher sensitivity and specificity than Vp < 0.5 m s(-1) (96% and 87% vs. 73% and 84%, respectively). A comparison of receiver operating characteristic curves showed a significant difference for areas under the curve in favor of Em (P < 0.01). In a stepwise multiple logistic regression analysis, a pseudonormal filling pattern and an EF > 60% were identified as significant predictors of Vp false negative results (p < 0.05).


CONCLUSIONS
Em appears to be superior to Vp in the detection of mild to moderate LV diastolic dysfunction. Vp failed to detect abnormal LV diastolic function in particular in patients with preserved LV systolic function and a pseudonormal filling pattern type.
Palecek
Tomas
T
2nd Department of Internal Medicine, General University Hospital, 1st School of Medicine, Charles University, U nemocnice 2, 128 08 Prague 2, Czech Republic. tpalec@hotmail.com
Linhart
Ales
A
Bultas
Jan
J
Aschermann
Michael
M
D000328:Adult; D001783:Blood Flow Velocity; D003971:Diastole / Q000502:physiology*; D018618:Echocardiography, Doppler, Color / Q000379:methods*; D018619:Echocardiography, Doppler, Pulsed / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000503:physiopathology*; D013997:Time Factors; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000503:physiopathology