Differentiation of left ventricular diastolic function by mid-diastolic mitral annular motion patterns.
Mid-diastolic mitral annular motion may be driven by strain energy, an energy for myocardial recoil, stored during the previous systole. Hence, various patterns of mid-diastolic mitral annular motion may imply different left ventricular (LV) diastolic function. The purpose of this study is to compare LV diastolic properties among different types of mid-diastolic mitral annular motion. Two-hundred and three consecutive subjects underwent an echocardiographic examination at our outpatient clinic. Study subjects were classified into three groups according to mid-diastolic mitral annular motion patterns. Upward and downward La waves were defined, respectively, as a clear apically and atrially directed mid-diastolic annular motion on at least three consecutive beats with the average peak velocity > or =2 cm/s. Subjects with upward La wave, with downward but without upward La wave and without La wave were categorized as groups 1, 2 and 3, respectively. Early diastolic mitral annular velocity (Ea) was higher and the ratio of transmitral E wave velocity to Ea was lower in group 1 than in groups 2 and 3 (all p < 0.001). The diagnostic accuracy of upward La wave in prediction of normal diastolic function fell between 75% and 88%. In conclusion, patients with upward La wave had better LV diastolic function and lower LV filling pressure than patients without it. Upward La wave is useful in prediction of normal diastolic function. Therefore, analysis of mid-diastolic mitral annular motion may be complementary to other measures of LV diastolic function. (
Su
Ho-Ming
HM
Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Lin
Tsung-Hsien
TH
Lee
Chee-Siong
CS
Yen
Hsueh-Wei
HW
Huang
Chih-Hsin
CH
Cheng
Kai-Hung
KH
Lee
Hsiang-Chun
HC
Lai
Wen-Ter
WT
Sheu
Sheng-Hsiung
SH
Voon
Wen-Chol
WC
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D003920:Diabetes Mellitus / Q000000981:diagnostic imaging; D003971:Diastole; D018619:Echocardiography, Doppler, Pulsed; D005260:Female; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity; D012815:Signal Processing, Computer-Assisted; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging; D016277:Ventricular Function, Left / Q000502:physiology*