title: A new parameter of pulsed-wave tissue Doppler imaging: IVRa.
abstract: OBJECTIVE
  We investigated how velocity of isovolumetric relaxation period on pulsed-wave tissue Doppler trace (IVRa and IVRb) is affected by the left ventricular (LV) geometry changes.
  
  
  METHODS
  Two hundred cases without exclusion criteria were included in the study. Normal LV mass index (LVMI) and normal relative wall thickness (RWT) was assigned to group 1 (n = 72). Concentric remodeling (normal LVMI and increased RWT) was defined to group 2 (n = 25). Eccentric LV hypertrophy (LVH) (increased LVMI and normal RWT) was defined to group 3 (n = 62). And finally, concentric LVH (increased LVMI and increased RWT) was defined to group 4 (n = 41).
  
  
  RESULTS
  Patients with LVH (groups 3 and 4) were older than group 1 (P = 0.017 and 0.001). It was observed in the assessment of M-mode ECHO parameters that the aortic valve diameter, aortic valve opening, LV end-systolic diameter (LVESD), LV end-diastolic diameter (LVEDD), and left atrium (LA) were higher in cases with eccentric LVH. It was shown that Ea velocity and Sa velocity time integral (Sa-VTI) were decreased with LV geometry change. However, IVRa velocity and E/Ea were increased as LV geometry change. A positive correlation between IVRa velocity and LVMI (correlation ratio = 34%, P = 0.000) was found. Similarly, a positive correlation between IVRa velocity and RWT (correlation ratio = 17%, P = 0.025) was found.
  
  
  CONCLUSIONS
  IVRa velocity exhibits a positive correlation with LV geometry changes indicating that IVRa velocity is affected by LV geometry like the other parameters influenced by LV geometry.
authors.affiliation: Cardiology Department, Private Avcilar Anadolu Hospital, Istanbul, Turkey. huseyinsurucu@yahoo.com.tr
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Sürücü
authors.forename: Ersan
authors.initials: E
authors.lastname: Tatli
authors.forename: Ali
authors.initials: A
authors.lastname: Değirmenci
authors.forename: Selnur
authors.initials: S
authors.lastname: Okudan
authors.forename: Meryem
authors.initials: M
authors.lastname: Aktoz
authors.forename: Hakki
authors.initials: H
authors.lastname: Boz
mesh_terms: D000328:Adult; D003971:Diastole; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis* / Q000503:physiopathology