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?
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.
Oyama
Rikimaru
R
Division of Cardiovascular Medicine, Department of Medical Bioregulation, Yamaguchi University Graduate School of Medicine, Minami-Kogushi, Ube, Japan.
Murata
Kazuya
K
Tanaka
Nobuaki
N
Takaki
Akira
A
Ueda
Kayo
K
Liu
Jinyao
J
Wada
Yasuaki
Y
Harada
Nozomu
N
Okuda
Shinichi
S
Hamada
Yoko
Y
Matsuzaki
Masunori
M
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
D020097:Natriuretic Peptide, Brain