title: Is the ratio of transmitral peak E-wave velocity to color flow propagation velocity useful for evaluating the severity of heart failure in atrial fibrillation?
abstract: BACKGROUND
  Although analysis of the transmitral inflow (TMF) pattern is widely used for evaluating left ventricular diastolic function and provides valuable information for the management of heart failure (HF) in sinus rhythm, its utility in patients with atrial fibrillation (AF) has not been established. The aim of this study was to investigate the relationship between the ratio of transmitral peak E-wave velocity to flow propagation velocity (E/Vp) obtained by a newly developed dual Doppler system and the plasma B-type natriuretic peptide (BNP) concentration or pulmonary capillary wedge pressure (PCWP) for evaluating the severity of heart failure with AF.
  
  
  RESULTS
  In 68 patients with AF, the E/Vp was compared with plasma BNP concentration and PCWP. A cutoff value of > or =1.7 for E/Vp predicted a plasma BNP concentrationl of > or =200 pg/ml, with 80% sensitivity and 84% specificity. Only E/Vp was found to be independently significant by stepwise multilinear regression analysis (r=0.40, p=0.01). PCWP values had good correlation with E/Vp (r=0.63, p<0.01) and were significantly higher in the group with E/Vp >/=1.7 (16+/-6 mmHg vs 11+/-4 mmHg, p<0.05).
  
  
  CONCLUSIONS
  The Doppler-derived index of E/Vp correlated well with the neurohormonal and hemodynamic parameters, and was useful for evaluating the severity of heart failure with AF.
authors.affiliation: Division of Cardiovascular Medicine, Department of Medical Bioregulation, Yamaguchi University Graduate School of Medicine, Minami-Kogushi, Ube, Japan.
authors.forename: Rikimaru
authors.initials: R
authors.lastname: Oyama
authors.forename: Kazuya
authors.initials: K
authors.lastname: Murata
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Tanaka
authors.forename: Akira
authors.initials: A
authors.lastname: Takaki
authors.forename: Kayo
authors.initials: K
authors.lastname: Ueda
authors.forename: Jinyao
authors.initials: J
authors.lastname: Liu
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Wada
authors.forename: Nozomu
authors.initials: N
authors.lastname: Harada
authors.forename: Shinichi
authors.initials: S
authors.lastname: Okuda
authors.forename: Yoko
authors.initials: Y
authors.lastname: Hamada
authors.forename: Masunori
authors.initials: M
authors.lastname: Matsuzaki
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications*; D001783:Blood Flow Velocity; D002303:Cardiac Output, Low / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology*; D004452:Echocardiography / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D020097:Natriuretic Peptide, Brain / Q000097:blood; D011669:Pulmonary Wedge Pressure; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index
chemical_list: D020097:Natriuretic Peptide, Brain