Clinical usefulness of tissue Doppler imaging in patients with mild to moderate aortic stenosis: a substudy of the aortic stenosis progression observation measuring effects of rosuvastatin study.
OBJECTIVE
Although impaired diastolic function is common in aortic stenosis (AS), little is known about the clinical usefulness of tissue Doppler imaging (TDI) to detect diastolic dysfunction in patients with mild to moderate AS. The objective was to describe both conventional and TDI measurements of diastolic function in asymptomatic patients enrolled in the Aortic Stenosis Progression Observation Measuring Effects of Rosuvastatin study, a multicenter study to assess the effect of rosuvastatin on the progression of AS.


METHODS
Baseline echocardiography measurements, including left ventricular interventricular septal thickness, posterior wall thickness, cavity dimensions, and ejection fraction were obtained. Conventional Doppler indices, including peak early (E) and late (A) transmitral velocities, E/A ratio, and E-wave deceleration time, were measured from spectral Doppler. Tissue Doppler measurements, including early (E') and late (A') velocities of the lateral annulus, were determined, and E/E' was calculated.


RESULTS
The study population included 172 patients (aged 57 +/- 13 years; 73 were female) divided into three categories of AS severity on the basis of peak velocity at baseline (group I: 2.5-3.0 m/s; group II: 3.1-3.5 m/s; group III; 3.6-4.0 m/s). Baseline hemodynamics, left ventricular dimensions, and conventional diastolic functional parameters were similar among all 3 groups. In patients with greater severity of AS, the lateral E' was lower and the E/E' (as an estimate of increased left ventricular end-diastolic pressure) was higher (P <.05).


CONCLUSIONS
In patients with mild to moderate asymptomatic AS, TDI measures of diastolic function are abnormal and related to the severity of AS. These findings may help to predict the future development of symptoms in this population.
Jassal
Davinder S
DS
Cardiology Division, Department of Cardiac Sciences, St. Boniface General Hospital, Winnipeg, Manitoba, Canada.
Tam
James W
JW
Dumesnil
Jean G
JG
Giannoccaro
Peter J
PJ
Jue
John
J
Pandey
A Shekhar
AS
Joyner
Campbell D
CD
Teo
Koon K
KK
Chan
Kwan L
KL
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D005464:Fluorobenzenes / Q000627:therapeutic use*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011743:Pyrimidines / Q000627:therapeutic use*; D015203:Reproducibility of Results; D000068718:Rosuvastatin Calcium; D012680:Sensitivity and Specificity; D013449:Sulfonamides / Q000627:therapeutic use*; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology / Q000517:prevention & control*; D055815:Young Adult
D005464:Fluorobenzenes; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011743:Pyrimidines; D013449:Sulfonamides; D000068718:Rosuvastatin Calcium