Determinants of preserved diastolic function at the lateral annulus in patients with isolated diastolic dysfunction.
OBJECTIVE
The reversal of the early diastolic mitral annular velocity (e') to the late diastolic mitral annular velocity (a') ratio (e'/a' <1) develops earlier in the septum than in the lateral mitral annulus on tissue Doppler imaging (TDI). Accordingly, patients with isolated diastolic dysfunction presenting as a reversed septal e'/a' ratio can be divided into two groups depending on the presence of a reversal of lateral e'/a'. The aim of this study was to identify the determinants of preserved diastolic function at the lateral annulus in patients with isolated diastolic dysfunction.


RESULTS
A total of 1166 consecutive patients with isolated diastolic dysfunction presenting as a reversed septal e'/a' were classified on the basis of their diastolic function at the lateral mitral annulus. Two hundred and fifteen patients had a preserved lateral e'/a' (e'/a' >1) and 915 patients had a reversed lateral e'/a' (e'/a' <1). Patients with lateral e'/a' >1 were younger, male, and had a lower prevalence of diabetes and hypertension and showed less evidence of left ventricular (LV) diastolic dysfunction and structural remodelling as LV hypertrophy and LA enlargement, than those with a lateral e'/a' <1. Multivariate analysis revealed that age, septal e', septal peak systolic annular velocity, and LV mass indexed to height(2.7) (LVM/h(2.7)) were independently associated with preserved diastolic function at the lateral annulus.


CONCLUSIONS
The age, septal TDI, and LVM/h(2.7) were independent determinants of preserved diastolic function at the lateral annulus in patients with isolated diastolic dysfunction presenting as a reversed septal e'/a' ratio.
Division of Cardiology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, # 896, Pyeongchon-dong, Dongan-gu, Anyang-Si, Gyeonggi-do 431-070, Korea.
Sung-Ai
SA
Kim
Woo-Jung
WJ
Park
Ho Joong
HJ
Kim
Sang-Ho
SH
Jo
Hyun-Sook
HS
Kim
Sang-Jin
SJ
Han
Chong-Yun
CY
Rhim
D000328:Adult; D000367:Age Factors; D000368:Aged; D015331:Cohort Studies; D003971:Diastole / Q000502:physiology; D004452:Echocardiography / Q000379:methods*; D018619:Echocardiography, Doppler, Pulsed / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006334:Heart Function Tests; D006346:Heart Septum / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging* / Q000503:physiopathology; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000503:physiopathology