Clinical utility of single-beat E/e' obtained by simultaneous recording of flow and tissue Doppler velocities in atrial fibrillation with preserved systolic function.
OBJECTIVE
We evaluated the usefulness of the ratio of the early diastolic transmitral flow velocity (E) to the mitral annular velocity (e') calculated from simultaneously recorded E and e' in atrial fibrillation (AF).


BACKGROUND
The ratio of the E to the e' (E/e') has been reported as a useful index even in AF patients. However, E and e' were measured during different beats in the previous studies.


METHODS
Fifty-six AF patients with preserved systolic function (mean age 66 +/- 11 years) underwent routine echocardiographic study. The E/e' was calculated from the E and e' simultaneously recorded by the dual Doppler echocardiography. A single-beat E/e' was calculated from simultaneously recorded E and e' when the preceding RR interval/pre-preceding RR interval = 1. Brain natriuretic peptide (BNP) levels were also examined. Twenty-one patients underwent simultaneous pulmonary artery catheterization.


RESULTS
The single-beat lateral E/e' correlated with pulmonary capillary wedge pressure (PCWP) (r = 0.74, p < 0.001). The single-beat lateral E/e' of >or=11 could predict elevated PCWP (>or=15 mm Hg) with a sensitivity of 90% and a specificity of 90%. The single-beat lateral E/e' also correlated well with the log BNP concentration. The single-beat lateral E/e' of >or=9.2 predicted a plasma BNP level of >or=200 pg/ml with 88% sensitivity and 84% specificity.


CONCLUSIONS
The single-beat lateral E/e' correlated with plasma BNP level and PCWP in AF patients with preserved systolic function. In addition, the single-beat lateral E/e' (>or=11) was a good predictor of elevated PCWP (>or=15 mm Hg). Dual Doppler echocardiography offers an advantage of providing the single-beat lateral E/e' correctly even in AF patients, for the evaluation of left ventricular diastolic function.
Kusunose
Kenya
K
Department of Cardiovascular Medicine, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan.
Yamada
Hirotsugu
H
Nishio
Susumu
S
Tomita
Noriko
N
Niki
Toshiyuki
T
Yamaguchi
Koji
K
Koshiba
Kunihiko
K
Yagi
Shusuke
S
Taketani
Yoshio
Y
Iwase
Takashi
T
Soeki
Takeshi
T
Wakatsuki
Tetsuzo
T
Akaike
Masashi
M
Sata
Masataka
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging* / Q000503:physiopathology; D015415:Biomarkers / Q000097:blood; D002407:Catheterization, Swan-Ganz; D003326:Coronary Circulation; D003971:Diastole; D018618:Echocardiography, Doppler, Color; D018619:Echocardiography, Doppler, Pulsed; D005260:Female; D006339:Heart Rate; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging* / Q000503:physiopathology; D020097:Natriuretic Peptide, Brain / Q000097:blood; D011237:Predictive Value of Tests; D011669:Pulmonary Wedge Pressure; D012680:Sensitivity and Specificity; D013599:Systole; D016277:Ventricular Function, Left
D015415:Biomarkers; D020097:Natriuretic Peptide, Brain