title: Additional value of lateral tissue Doppler imaging in the assessment of diastolic dysfunction among subjects with pseudonormal pattern of mitral inflow.
abstract: BACKGROUND
  There has been a lack of research on further stratification of subjects who have pseudonormal pattern of mitral inflow. The study aim was to clarify 2 different groups with different diastolic function grades among these subjects using lateral tissue Doppler imaging (TDI).
  
  
  METHODS
  A total of 122 consecutive subjects showing pseudonormal pattern of mitral inflow (E/A ≥ 1 and septal e'/a' < 1) without structural abnormality were prospectively recruited. TDI measurements were performed from both septal and lateral mitral annuli.
  
  
  RESULTS
  Study subjects were stratified according to lateral TDI pattern (e'/a' < 1 [n = 50] versus e'/a' ≥ 1 [n = 72]). Subjects with lateral e'/a' < 1 had higher values of left atrial volume index (LAVI) and E/e' compared to those for lateral e'/a' ≥ 1 (p < 0.001 for each). Among subjects with lateral e'/a' ≥ 1, only 9.3% of subjects had grade II diastolic dysfunction, whereas among subjects with lateral e'/a' < 1, majority of subjects (64.1%) had grade II diastolic dysfunction (p < 0.001). Multiple linear regression analysis showed that lateral e'/a' was independently associated with LAVI (β = -0.484, p < 0.001), even after adjusting for potential confounders including age, sex, body mass index, hypertension and diabetes.
  
  
  CONCLUSIONS
  In subjects without structural abnormality showing E/A ≥ 1 and septal e'/a' < 1, lateral TDI measurement is useful in the assessment of diastolic dysfunction. Lateral e'/a' ≥ 1 is a valuable indicator of early diastolic dysfunction but not of advanced diastolic dysfunction in this population.
authors: Cardiovascular Center, Seoul National University Boramae Medical Center, Seoul, Korea. jooheezo@hanmail.net.
authors: Hack-Lyoung
authors: HL
authors: Kim
authors: Joo-Hee
authors: JH
authors: Zo
authors: Jae-Bin
authors: JB
authors: Seo
authors: Woo-Young
authors: WY
authors: Chung
authors: Yong-Jin
authors: YJ
authors: Kim
authors: Sang-Hyun
authors: SH
authors: Kim
authors: Myung-A
authors: MA
authors: Kim
authors: Dae-Won
authors: DW
authors: Sohn
mesh_terms: D015897:Comorbidity; D015150:Echocardiography, Doppler / Q000706:statistics & numerical data*; D054459:Elasticity Imaging Techniques / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D015995:Prevalence; D011379:Prognosis; D015203:Reproducibility of Results; D056910:Republic of Korea / Q000453:epidemiology; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000453:epidemiology*
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