Simultaneous Doppler Tracing of Transmitral Inflow and Mitral Annular Velocity as an Estimate of Elevated Left Ventricular Filling Pressure in Patients With Atrial Fibrillation

Background: The time interval between the onset of early transmitral flow velocity (E) and that of early diastolic mitral annular velocity (e') (TE-e') is a good predictor of elevated left ventricular (LV) filling pressure in patients with sinus rhythm. Although the evaluation of LV fillin...

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Bibliographic Details
Published in:Circulation Journal 2012, Vol.76(3), pp.675-681
Main Authors: Wada, Yasuaki, Murata, Kazuya, Tanaka, Takeo, Nose, Yoshio, Kihara, Chikage, Uchida, Kosuke, Okuda, Shinichi, Susa, Takehisa, Kishida, Yukari, Matsuzaki, Masunori
Format: Article
Language:English
Subjects:
Aged
Atrial fibrillation
Atrial Fibrillation - diagnostic imaging
Atrial Fibrillation - physiopathology
Echocardiography, Doppler - methods
Female
Humans
Left ventricular filling pressure
Male
Middle Aged
Mitral Valve - diagnostic imaging
Mitral Valve - physiopathology
Regional Blood Flow
Sensitivity and Specificity
Tissue Doppler echocardiography
Ventricular Dysfunction, Left - diagnosis
Ventricular Dysfunction, Left - diagnostic imaging
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Summary:Background: The time interval between the onset of early transmitral flow velocity (E) and that of early diastolic mitral annular velocity (e') (TE-e') is a good predictor of elevated left ventricular (LV) filling pressure in patients with sinus rhythm. Although the evaluation of LV filling pressure using E/e' has been challenging in atrial fibrillation (AF), the usefulness of TE-e' is unknown. Methods and Results: E and e' were simultaneously recorded using dual Doppler echocardiography in 45 AF patients (30 men; mean age, 69±9 years). E/e' and TE-e' were calculated and compared with the pulmonary capillary wedge pressure (PCWP), which was measured invasively. E/e' and TE/e' correlated with PCWP (E/e', r=0.57, P34ms and E/e' >14.6 were used, the sensitivity and specificity of predicting elevated PCWP were improved to 100% and 88%, respectively. Conclusions: In AF patients, the simultaneous recording of E and e' using dual Doppler echocardiography and the analysis of TE-e', in addition to E/e', improved the accuracy of evaluation of LV filling pressure. (Circ J 2012; 76: 675-681)
ISSN:1346-9843
1347-4820
DOI:10.1253/circj.CJ-11-0703