title: Assessment of elevation of and rapid change in left ventricular filling pressure using a novel global strain imaging diastolic index.
abstract: BACKGROUND
  The aim of this study was to determine whether global strain imaging diastolic index (SIDI) obtained using 2-D speckle tracking imaging (2DSI) could predict elevation in and rapid change of LV filling pressure.
  
  
  RESULTS
  Patients (n=126) underwent echocardiography and 2DSI during simultaneous cardiac catheterization. There were 60 patients in whom the same measurements were repeated 5min after i.v. glyceryl trinitrate. LV pre-atrial contraction pressure (pre-A) was measured as a surrogate of LV filling pressure. SIDI was defined as the change of LV longitudinal strain measured using 2DSI during the first one-third of diastole. Then, longitudinal global SIDI (L-global SIDI) was calculated as the mean SIDI of 18 LV segments. Mitral inflow and tissue Doppler imaging were also assessed. Among 126 patients, 93 patients had LV pre-A ≥15mmHg. L-global SIDI had a better correlation with LV pre-A (P<0.001, r=-0.56) than E/e' (P<0.01, r=0.35). On receiver operating characteristic curve analysis, L-global SIDI <0.48 was the optimum cut-off to predict LV pre-A ≥15mmHg (sensitivity, 82%; specificity, 68%). In addition, the ratio of L-global SIDI (after nitrate/before nitrate) was correlated with the ratio of LV pre-A (after nitrate/before nitrate; P=0.02, r=-0.34).
  
  
  CONCLUSIONS
  A novel L-global SIDI derived from 2DSI may reflect elevated LV filling pressure and its rapid change better than conventional diastolic parameters.
authors: Division of Cardiology, Department of Internal Medicine, Taipei Medical University Hospital.
authors: Shuo-Ju
authors: SJ
authors: Chiang
authors: Masao
authors: M
authors: Daimon
authors: Katsuhisa
authors: K
authors: Ishii
authors: Takayuki
authors: T
authors: Kawata
authors: Sakiko
authors: S
authors: Miyazaki
authors: Kuniaki
authors: K
authors: Hirose
authors: Ryoko
authors: R
authors: Ichikawa
authors: Katsumi
authors: K
authors: Miyauchi
authors: Mei-Hsiu
authors: MH
authors: Yeh
authors: Nen-Chung
authors: NC
authors: Chang
authors: Hiroyuki
authors: H
authors: Daida
mesh_terms: D000368:Aged; D001794:Blood Pressure; D003971:Diastole; D018618:Echocardiography, Doppler, Color / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged