title: Clinical utility of single-beat E/e' obtained by simultaneous recording of flow and tissue Doppler velocities in atrial fibrillation with preserved systolic function.
abstract: 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.
authors.affiliation: Department of Cardiovascular Medicine, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan.
authors.forename: Kenya
authors.initials: K
authors.lastname: Kusunose
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Yamada
authors.forename: Susumu
authors.initials: S
authors.lastname: Nishio
authors.forename: Noriko
authors.initials: N
authors.lastname: Tomita
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Niki
authors.forename: Koji
authors.initials: K
authors.lastname: Yamaguchi
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Koshiba
authors.forename: Shusuke
authors.initials: S
authors.lastname: Yagi
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Taketani
authors.forename: Takashi
authors.initials: T
authors.lastname: Iwase
authors.forename: Takeshi
authors.initials: T
authors.lastname: Soeki
authors.forename: Tetsuzo
authors.initials: T
authors.lastname: Wakatsuki
authors.forename: Masashi
authors.initials: M
authors.lastname: Akaike
authors.forename: Masataka
authors.initials: M
authors.lastname: Sata
mesh_terms: 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
chemical_list: D015415:Biomarkers; D020097:Natriuretic Peptide, Brain