Assessment of Mitral Annulus Velocity by Doppler Tissue Imaging in the Evaluation of Left Ventricular Diastolic Function

• Published in: Journal of the American College of Cardiology 1997-08, Vol.30 (2), p.474-480
• Main Authors: Sohn, Dae-Won, Chai, In-Ho, Lee, Dong-Jun, Kim, Hee-Chan, Kim, Hyo-Soo, Oh, Byung-Hee, Lee, Myoung-Mook, Park, Young-Bae, Choi, Yun-Shik, Seo, Jung-Don, Lee, Young-Woo
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Cardiovascular system; Diastole - physiology; Echocardiography, Doppler; Female; Humans; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Middle Aged; Mitral Valve - physiology; Nitroglycerin - pharmacology; Ultrasonic investigative techniques; Vasodilator Agents - pharmacology; Ventricular Function, Left - physiology
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/S0735-1097(97)88335-0

Objectives. This study assessed the clinical utility of mitral annulus velocity in the evaluation of left ventricular diastolic function. Background. Mitral inflow velocity recorded by Doppler echocardiography has been widely used to evaluate left ventricular diastolic function but is affected by other factors. The mitral annulus velocity profile during diastole may provide additional information about left ventricular diastolic function. Methods. Mitral annulus velocity during diastole was measured by Doppler tissue imaging (DTI) 1) in 59 normal volunteers (group 1); 2) in 20 patients with a relaxation abnormality as assessed by Doppler mitral inflow variables (group 2) at baseline and after saline loading; 3) in 11 patients (group 3) with normal diastolic function before and after intravenous nitroglycerin infusion; and 4) in 38 consecutive patients (group 4) undergoing cardiac catheterization in whom mitral inflow velocity and tau as well as mitral annulus velocity were measured simultaneously. Results. In group 1, mean ± SD peak early and late diastolic mitral annulus velocity was 10.0 ± 1.3 and 9.5 ± 1.5 cm/s, respectively. In group 2, mitral inflow velocity profile changed toward the pseudonormalization pattern with saline loading (deceleration time 311 ± 84 ms before to 216 ± 40 ms after intervention, p < 0.001), whereas peak early diastolic mitral annulus velocity did not change significantly (5.3 ± 1.2 cm/s to 5.7 ± 1.4 cm/s, p = NS). In group 3, despite a significant change in mitral inflow velocity profile after nitroglycerin, peak early diastolic mitral annulus velocity did not change significantly (9.5 ± 2.2 cm/s to 9.2 ± 1.7 cm/s, p = NS). In group 4, peak early diastolic mitral annulus velocity (r = −0.56, p < 0.01) and the early/late ratio (r = −0.46, p < 0.01) correlated with tau. When the combination of normal mitral inflow variables with prolonged tau (≥50 ms) was classified as pseudonormalization, peak early diastolic mitral annulus velocity