© 2004 by European Society of Cardiology
Copyright © 2003, The European Society of Cardiology
Comparison of early diastolic mitral annular velocity and flow propagation velocity in detection of mild to moderate left ventricular diastolic dysfunction
2nd Department of Internal Medicine, General University Hospital, 1st School of Medicine, Charles University, U nemocnice 2, 128 08 Prague 2, Czech Republic
Received 24 February 2003; received in revised form 16 September 2003; accepted after revision 17 September 2003.
tpalec{at}hotmail.com
* Corresponding author. Tel.: +420-224-962-634; fax: +420-224-912-154.
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Abstract |
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Background: Pulsed wave tissue Doppler echocardiography (PW-TDE) and color M-mode are new Doppler methods for left ventricular (LV) diastolic function assessment. To date, few studies have compared the data obtained by these methods in the same series of patients and compared them to the current clinical reference method of detecting LV diastolic function.
Aims: To determine the utility of PW-TDE and color M-mode parameters in the assessment of LV diastolic function in the typical patient population encountered in daily clinical practice and to compare their discriminating power.
Methods: Early diastolic septal mitral annular velocity (Em) determined by PW-TDE and color M-mode flow propagation velocity (Vp) were measured in 86 male patients and compared to LV filling patterns obtained using standard Doppler indices. Values of Em<0.08 m s–1 and Vp<0.5 m s–1 were considered as markers of abnormal LV diastolic function.
Results: A value of Em<0.08 m s–1 distinguished mild to moderate LV diastolic dysfunction with higher sensitivity and specificity than Vp<0.5 m s–1 (96% and 87% vs. 73% and 84%, respectively). A comparison of receiver operating characteristic curves showed a significant difference for areas under the curve in favor of Em (p<0.01). In a stepwise multiple logistic regression analysis, a pseudonormal filling pattern and an EF > 60% were identified as significant predictors of Vp false negative results (p<0.05).
Conclusions: Em appears to be superior to Vp in the detection of mild to moderate LV diastolic dysfunction. Vp failed to detect abnormal LV diastolic function in particular in patients with preserved LV systolic function and a pseudonormal filling pattern type.
Keywords: diastolic function; early diastolic mitral annular velocity; flow propagation velocity; echocardiography
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