Does mitral annulus motion provide comparable or additional information to Doppler flow velocities for assessing left ventricular diastolic function in patients with heart failure after myocardial infarction?
Mitral annulus motion correlates significantly with Doppler flow velocities but provides non-identical information, suggesting it may be a useful adjunct for assessing left ventricular relaxation abnormalities.
Mitral and pulmonary venous flow velocity recordings are often used for the assessment of left ventricular diastolic function. These curves are, however, also influenced by other factors. To investigate whether mitral annulus motion carries additional information in this context, mitral annulus motion was compared to Doppler registrations of mitral and pulmonary flow velocities in 38 patients with heart failure (NYHA II-III) after myocardial infarction. Patients with an increased atrial contribution to mitral annulus motion (> 57%, n = 12) had a higher mitral late-to-early flow velocity ratio (A/E) and pulmonary systolic to diastolic filling ratio ( or = 5.1 mm, n = 19) had a higher mitral (A/E) ratio and pulmonary systolic to diastolic filling ratio than patients with a lower than average atrial component (P < 0.05). There was a significant correlation between a/T ratio and A/E ratio (r = 0.61, P < 0.001) and between pulmonary flow and transmitral flow (= 0.76, P < 0.001). We conclude that an increased atrial displacement of the mitral annulus is a frequent finding in patients with signs of left ventricular relaxation abnormality. There is a significant correlation between a/T ratio and A/E ratio but the information contained in the two indices are not identical.
Blomstrand et al. (1996) studied this question.