title: Effect of preload alterations by hemodialysis on the time interval between the onsets of early diastolic mitral inflow and annular waveforms.
abstract: BACKGROUND
  The T(Ea-E), which is defined as the time interval between the peak of the R-wave and the onset of early diastolic mitral annular waveform (T(Ea)) minus the time interval between the peak of the R-wave and the onset of early diastolic mitral inflow waveform (T(E)), is recently proposed as a useful index of left ventricular (LV) relaxation. The aim of this study is to determine whether the T(Ea-E) is preload-independent.
  
  
  METHODS
  Twenty hemodialysis (HD) patients (9 men; age 64 +/- 9 years) underwent echocardiography 1 hour before and 1 hour after HD was studied.
  
  
  RESULTS
  After HD, the body weight (P < 0.001), early transmitral filling wave peak velocity (E) (P < 0.001), the ratio of E to late transmitral filling wave peak velocity (P = 0.011), the early diastolic mitral anuular velocity (Ea) (P = 0.002), E/Ea (P = 0.026), and T(Ea-E) (P < 0.001) decreased significantly, and the T(Ea) (P = 0.047) and T(E) (P = 0.005) increased significantly. In addition, T(Ea-E) had a significant negative correlation with Ea either before (r =-0.457, P = 0.043) or after HD (r =-0.637, P = 0.003).
  
  
  CONCLUSIONS
  T(Ea-E), as well as Ea, was a preload-dependent relaxation index. The preload dependence of this newer Doppler parameter limited its utility in evaluating LV diastolic function in HD patients.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan.
authors.forename: Ho-Ming
authors.initials: HM
authors.lastname: Su
authors.forename: Tsung-Hsien
authors.initials: TH
authors.lastname: Lin
authors.forename: Wen-Chol
authors.initials: WC
authors.lastname: Voon
authors.forename: Hung-Chun
authors.initials: HC
authors.lastname: Chen
authors.forename: Kun-Tai
authors.initials: KT
authors.lastname: Lee
authors.forename: Ye-Hsu
authors.initials: YH
authors.lastname: Lu
authors.forename: Wen-Ter
authors.initials: WT
authors.lastname: Lai
authors.forename: Sheng-Hsiung
authors.initials: SH
authors.lastname: Sheu
mesh_terms: D000368:Aged; D001783:Blood Flow Velocity; D003971:Diastole / Q000502:physiology*; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging*; D006435:Renal Dialysis; D013997:Time Factors; D016277:Ventricular Function, Left