title: Dobutamine stress echocardiography Doppler estimation of cardiac diastolic function: a simultaneous catheterization correlation study.
abstract: BACKGROUND
  Doppler echocardiography using the ratio of early diastolic transmitral velocity to early diastolic mitral annular tissue velocity (E/E') is routinely used to evaluate left ventricular (LV) filling pressures at rest. We tested the hypothesis that measurement of E/E' in patients undergoing dobutamine stress echocardiography (DSE) will detect changes in LV filling pressures.
  
  
  METHODS
  In this prospective study, 16 patients with normal LV ejection fraction and normal coronary arteries by angiography underwent a standard DSE protocol with simultaneous LV filling pressure monitoring with a fluid filled pigtail catheter. Doppler echocardiographic assessment of LV diastolic function was performed using E/E' at rest and during DSE.
  
  
  RESULTS
  The average age of the study participants was 57 ± 8 years. Average heart rate was 61 ± 11 bpm at baseline and 141 ± 12 bpm at peak stress. LV mean diastolic pressure decreased from 12.3 ± 2.6 mmHg at baseline to 9.0 ± 2.3 mmHg at peak stress (P = 0.0001). Baseline E/E' at the septum and lateral annulus were 8.7 ± 2.2 and 7.5 ± 1.9 and during peak stress were 8.3 ± 3.1 and 7.9 ± 3.5, respectively. There was no significant change in E/E' at either the septum or the lateral annulus (P = 0.55, P = 0.66). There was no significant correlation between LV mean diastolic pressure and E/E' with dobutamine stress.
  
  
  CONCLUSIONS
  In patients with normal LV ejection fraction and no significant coronary artery disease undergoing DSE, the ratio of early diastolic transmitral velocity to early diastolic tissue velocity (E/E') at peak stress with dobutamine does not predict changes in LV filling pressures.
authors.affiliation: Cardiology Section, Harry S. Truman Memorial Veterans' Hospital, Columbia, Missouri, USA.
authors.forename: Albert K
authors.initials: AK
authors.lastname: Chan
authors.forename: Gurushankar
authors.initials: G
authors.lastname: Govindarajan
authors.forename: Marc L
authors.initials: ML
authors.lastname: Del Rosario
authors.forename: Kul
authors.initials: K
authors.lastname: Aggarwal
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Dellsperger
authors.forename: Anand
authors.initials: A
authors.lastname: Chockalingam
mesh_terms: D006328:Cardiac Catheterization; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D003971:Diastole / Q000502:physiology*; D025401:Echocardiography, Stress; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric