title: Will simultaneous measurement of E/e' index facilitate the non-invasive assessment of left ventricular filling pressure in patients with non-valvular atrial fibrillation?
abstract: OBJECTIVE
  The ratio of early transmitral flow velocity (E) to early diastolic mitral annular velocity (e') was applied as a non-invasive index to assess left ventricular filling pressure (LVFP). However, the reliability of E/e' was undermined in patients with atrial fibrillation (AF). Recently, a novel method entitled 'dual Doppler' was established, which allows simultaneous recording and display of E and e'. Our study investigates whether the dual-Doppler method improves the reliability of E/e' in AF patients.
  
  
  RESULTS
  Forty-nine patients with non-valvular AF underwent conventional echocardiography, dual-Doppler echocardiography, and cardiac catheterization within 4 h. Of 22 patients (45%c) with increased LVFP (>15 mmHg), higher E/e' measured by both conventional tissue Doppler imaging (TDI) and dual-Doppler method was observed. Conventional echocardiographic variables were correlated with LVFP (E/e'(sep), r = 0.404, E/e'(lat), r = 0.487), but E/e' measured synchronously in the dual-Doppler mode yielded a better correlation (E/e'(synchronous sep), r = 0.754, E/e'(synchronous lat), r = 0.765). The intra- and interobserver variability of the dual-Doppler method was significantly lower than the conventional TDI method.
  
  
  CONCLUSIONS
  Good correlations were found between E/e'' and LVFP in patients with AF, particularly in the dual-Doppler mode. E/e' measured by the dual-Doppler method can therefore be applied to assess diastolic dysfunction in AF patients.
authors.affiliation: Department of Cardiology, West China Hospital of Sichuan University, 37 Guo Xue Xiang, Chengdu, Sichuan 610041, PR China.
authors.forename: Chen
authors.initials: C
authors.lastname: Li
authors.forename: Juqian
authors.initials: J
authors.lastname: Zhang
authors.forename: Can
authors.initials: C
authors.lastname: Zhou
authors.forename: Liwei
authors.initials: L
authors.lastname: Huang
authors.forename: Hong
authors.initials: H
authors.lastname: Tang
authors.forename: Li
authors.initials: L
authors.lastname: Rao
mesh_terms: D001281:Atrial Fibrillation / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001794:Blood Pressure / Q000502:physiology*; D004452:Echocardiography / Q000379:methods; D018618:Echocardiography, Doppler, Color / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D012680:Sensitivity and Specificity; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000503:physiopathology*