Clinical validity of measuring time difference between onset of mitral inflow and onset of early diastolic mitral annulus velocity in the evaluation of left ventricular diastolic function.
OBJECTIVE
This study was performed to validate the clinical usefulness of measuring the time difference between onset of mitral inflow and onset of early diastolic mitral annulus velocity (T(E'-E)) for the evaluation of left ventricular (LV) diastolic function.


BACKGROUND
In recent studies, T(E'-E) correlated well with the time constant of LV pressure decay (tau), and the ratio of IVRT/T(E'-E), where IVRT is isovolumic relaxation time, was useful in the prediction of elevated LV filling pressure.


METHODS
Simultaneous left heart catheterization and Doppler echocardiography were performed in 40 patients.


RESULTS
The T(E'-E) was evaluated in the same cardiac cycle and in the same hemodynamic status in 31 patients. Despite the wide range of tau (31 to 70 ms), there was no delay in the onset of mitral annulus velocity compared with the onset of mitral inflow (T(E'-E) = 0) in 27 patients and, therefore, T(E'-E) did not correlate with tau. Only three patients showed prolongation in T(E'-E), and all three showed tau >or=50 ms and pre-A-wave pressure >or=18 mm Hg. In one patient, mitral annulus velocity began earlier than the onset of mitral inflow. Because T(E'-E) was 0 in the majority of patients, the LV filling pressure could not be predicted by the previously suggested index of IVRT/T(E'-E.)


CONCLUSIONS
In contrast to previous studies, T(E'-E) did not correlate with tau, and IVRT/ T(E'-E) could not be applied in the prediction of filling pressure, because of the limitation of a zero denominator. However, prolongation of T(E'-E) might suggest an elevated filling pressure in the setting of prolonged tau.
Sohn
Dae-Won
DW
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea. dwsohn@snu.ac.kr
Kim
Young-Jin
YJ
Park
Young-Bae
YB
Choi
Yun-Shik
YS
D000328:Adult; D000368:Aged; D001783:Blood Flow Velocity; D003971:Diastole; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging* / Q000502:physiology*; D015203:Reproducibility of Results; D013997:Time Factors; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000503:physiopathology*