Why the study?
Echocardiographic assessment of LV diastolic function in AF is challenging because loss of atrial kick, beat-to-beat variability, and LA enlargement make guideline-based estimation difficult, necessitating additional echocardiographic parameters.
Do echocardiographic parameters like E/e' ratio, IVRT, E/Vp ratio, and DT of pulmonary venous diastolic wave accurately detect diastolic dysfunction in patients with atrial fibrillation?
Do echocardiographic parameters like E/e' ratio, IVRT, E/Vp ratio, and DT of pulmonary venous diastolic wave accurately detect diastolic dysfunction in patients with atrial fibrillation?
Echocardiographic parameters including E/e' ratio, IVRT, E/Vp ratio, and deceleration time of the diastolic pulmonary wave are highly sensitive for detecting diastolic dysfunction in patients with atrial fibrillation.
These parameters may aid diastolic dysfunction detection in atrial fibrillation; leaves open prospective validation before clinical adoption.
Background and Aims: Echocardiographic assessment of left ventricular diastolic function in patients with atrial fibrillation is a challenge as loss of atrial kick (A wave), beat to beat variability and left atrium enlargement despite normal atrial pressure make usual guideline based estimation difficult and inaccurate. Hence adoption of additional echocardiography parameters are necessary which are tricky and have varied results. Hence the aim of this study was to study various aspects of diastolic function in patients with atrial fibrillation. Methods: It was a hospital based prospective cross-sectional observational study conducted at cardiology unit, National Academy of Medical Sciences, Kathmandu and Shahid Gangalal National Heart Center, Kathmandu from 1st July 2018 to 30th June 2019. Results: Total of 92 patients were studied. About one third (34.8%) had diastolic dysfunction. Ratio of E/e’(14.65 ± 2.21 Vs 7.66 ± 1.18) , E/Vp (1.57 ± 0.14 Vs 1.20 ± 0.11), isovolumetric relaxation time (53.06 ± 13.82ms Vs 89.33 ± 9.88ms) and deceleration time of pulmonary venous diastolic wave (203.09 ± 26.13ms Vs 292.25 ± 36.32ms) were significantly different in patients with diastolic dysfunction compared to patients without diastolic dysfunction with sensitivity of 90.6%, 84.4%, 81.2% and 78.1% respectively. Conclusion: Diastolic dysfunction is a common entity in patients with atrial fibrillation. Echocardiography parameters like E/e’ ratio, isovolumetric relaxation time, E/Vp ratio and deceleration time of diastolic pulmonary wave were highly sensitive in detection of diastolic dysfunction.
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Adhikaree et al. (2019) studied this question.
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