Title of article :
Doppler Tissue Imaging: Noninvasive Technique for Evaluation of Left Ventricular Relaxation and Estimation of Filling Pressures
Author/Authors :
Sherif F. Nagueh MD، نويسنده , , Katherine J. Middleton RCT، نويسنده , , Helen A. Kopelen RDMS، نويسنده , , William A. Zoghbi MD FACC، نويسنده , , Miguel A. Qui?ones MD FACC، نويسنده ,
Issue Information :
روزنامه با شماره پیاپی سال 1997
Abstract :
Objectives. This investigation was designed 1) to assess whether the early diastolic velocity of the mitral annulus (Ea) obtained with Doppler tissue imaging (DTI) behaves as preload-independent index of left ventricular (LV) relaxation; and 2) to evaluate the relation of the mitral E/E ratio to LV filling pressures.
Background. Recent observations suggest that E is an index of LV relaxation that is less influenced by LV filling pressures.
Methods. One hundred twenty-five study subjects were classified into three groups according to mitral E/ ratio, LV ejection fraction (LVEF) and clinical symptoms: 34 asymptomatic subjects with normal LVEF and an E/ ratio ≥1; 40 with normal LVEF, an E/ ratio <1 and no heart failure symptoms (impaired relaxation [IR]); and 51 with heart failure symptoms and an E/ ratio >1 (pseudonormal [PN]). E was derived from the lateral border of the annulus. subset of 60 patients had invasive measurement of pulmonary capillary wedge pressure (PCWP) simultaneous with Doppler echocardiographic DTI.
Results. E was reduced in the IR and PN groups compared with the group of normal subjects: 5.8 ± 1.5 and 5.2 ± 1.4 vs. 12 ± 2.8 cm/s, respectively (p < 0.001). Mean PCWP (20 ± 8 mm Hg) related weakly to mitral E (r = 0.68) but not to Ea. The E/E ratio related well to PCWP (r = 0.87; PCWP = 1.24 [E/Ea] + 1.9), with difference between Doppler and catheter measurements of 0.1 ± 3.8 mm Hg.
Conclusions. E behaves as preload-independent index of LV relaxation. Mitral E velocity, corrected for the influence of relaxation (i.e., the E/E ratio), relates well to mean PCWP and may be used to estimate LV filling pressures.
Keywords :
AA , DTI , Left ventricular , IR , Pn , SA , pseudonormal , LV , LVEF , left ventricular ejection fraction , IVRT , PCWP , pulmonary capillary wedge pressure , Ea , Doppler tissue imaging , late diastolic velocity of mitral annulus , early diastolic velocity of mitral annulus , impaired relaxation , isovolumetric relaxation time , systolic velocity of mitral annulus
Journal title :
JACC (Journal of the American College of Cardiology)
Journal title :
JACC (Journal of the American College of Cardiology)