title: Early diastolic mitral annular velocity and color M-mode flow propagation velocity in the evaluation of left ventricular diastolic function in patients with Fabry disease.
abstract: Fabry disease is an X-linked genetic disorder characterized by progressive intracellular accumulation of neutral glycosphingolipids. Cardiac involvement is frequent and left ventricular (LV) diastolic dysfunction is present in most of the affected subjects. Pulsed-wave tissue Doppler echocardiography (PW-TDE) and color M-mode are new Doppler methods for LV diastolic function evaluation. Their role in the assessment of Fabry disease-related cardiomyopathy remains to be established. In this study we aimed to determine the utility of PW-TDE and color M-mode-derived parameters in the assessment of LV diastolic function in patients with Fabry disease. Eighty-one echocardiographic examinations performed in 35 patients affected by Fabry disease were retrospectively analyzed. Early diastolic lateral mitral annular velocity (E(m)) determined by PW-TDE and color M-mode flow propagation velocity (V(p)) were measured and compared to LV filling patterns obtained using standard Doppler indexes. The receiver operating characteristics (ROC) curves method was used to determine the summary measure of relative accuracy for E(m) and V(p). A comparison of ROC curves showed a significant difference for areas under the curve in favor of E(m) (P < 0.001). Pseudonormal filling pattern, higher LV mass index, higher relative wall thickness, larger left atrial diameter, and older age were more frequent (all P < 0.001) in patients with incorrect diagnosis of normal LV diastolic function based on the measurement of V(p). E(m) appears to be superior to V(p) in the assessment of LV diastolic function in patients with Fabry disease. V(p) fails to detect abnormal LV diastolic function in subjects with pronounced concentric LV remodeling and pseudonormal filling pattern.
authors.affiliation: Second Department of Internal Medicine, First School of Medicine, Charles University, U nemocnice 2, 128 08 Prague 2, Czech Republic, tpalec@hotmail.com.
authors.forename: Tomas
authors.initials: T
authors.lastname: Palecek
authors.forename: Ales
authors.initials: A
authors.lastname: Linhart
authors.forename: Jean Claude
authors.initials: JC
authors.lastname: Lubanda
authors.forename: Sudheera
authors.initials: S
authors.lastname: Magage
authors.forename: Debora
authors.initials: D
authors.lastname: Karetova
authors.forename: Jan
authors.initials: J
authors.lastname: Bultas
authors.forename: Michael
authors.initials: M
authors.lastname: Aschermann
mesh_terms: D000328:Adult; D019540:Area Under Curve; D001783:Blood Flow Velocity; D018618:Echocardiography, Doppler, Color; D018619:Echocardiography, Doppler, Pulsed; D000795:Fabry Disease / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005188:False Negative Reactions; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000503:physiopathology; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D012107:Research Design; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000503:physiopathology; D016277:Ventricular Function, Left; D020257:Ventricular Remodeling