title: Left ventricular diastolic function assessment using time differences between mitral annular velocities and transmitral inflow velocities in patients with heart failure.
abstract: BACKGROUND
  Evaluation of left ventricular (LV) diastolic function is important in clinical echocardiography. The relationship between mitral annular velocities and transmitral inflow velocities provide additional information about LV filling and diastolic function. This study evaluates the relationships of time intervals between peaks E of mitral inflow velocities and E' of mitral annular velocities, and peaks A and A' in patients with heart failure (HF).
  
  
  METHODS
  Eighty patients with HF and 50 age- and gender-matched normal healthy subjects were prospectively recruited and underwent full echocardiograms. The following time intervals were measured: (1) from the onset of R-wave on the ECG to the peak of E-wave on the transmitral flow (TMF) (R-pE); (2) from R to peak of E'-wave on the LV lateral wall of tissue Doppler imaging (TDI) (R-pE'); (3) from onset of P-wave to peak of A-wave on the TMF (P-pA); and (4) from onset of P-wave to peak of A'-wave (P-pA') of TDI. Early-diastolic temporal discordance (EDTD) and late-diastolic temporal discordance (LDTD) were calculated as the difference between the time intervals (R-E) and (R-E'), (P-pA) and (P-p A').
  
  
  RESULTS
  EDTD significantly decreased in patients with HF compared with normal subjects (18.0±54.1ms vs. 28.0±33.5ms, P<0.05). There was also a significant decrease in LDTD in HF patients compared with normal subjects (19.6±23.5ms vs. 34.8±20.6; P<0.05).
  
  
  CONCLUSIONS
  EDTD and LDTD decreased in patients with heart failure, and they may be useful tools in identifying abnormal LV relaxation and left atrial contraction for LV diastolic function.
authors.affiliation: National Heart Centre Singapore, Singapore.
authors.forename: Fei Qiong
authors.initials: FQ
authors.lastname: Huang
authors.affiliation: National Heart Centre Singapore, Singapore; DUKE-NUS Graduate Medical School, Singapore.
authors.forename: Ru San
authors.initials: RS
authors.lastname: Tan
authors.affiliation: National Heart Centre Singapore, Singapore; DUKE-NUS Graduate Medical School, Singapore.
authors.forename: David
authors.initials: D
authors.lastname: Sim
authors.affiliation: National Heart Centre Singapore, Singapore.
authors.forename: Thu Thao
authors.initials: TT
authors.lastname: Le
authors.affiliation: National Heart Centre Singapore, Singapore; DUKE-NUS Graduate Medical School, Singapore. Electronic address: zhong.liang@nhcs.com.sg.
authors.forename: Liang
authors.initials: L
authors.lastname: Zhong
mesh_terms: D000368:Aged; D001783:Blood Flow Velocity; D015150:Echocardiography, Doppler; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D016277:Ventricular Function, Left
keywords: Heart failure; LV relaxation; Pulsed tissue Doppler imaging; Temporal discordance; Time interval