Key result
Septal early diastolic mitral annular velocity excellently correlated with septal strain rate (r=0.90, p<0.001), reflecting left ventricular relaxation better than lateral annulus measurements.
Why the study?
Does early diastolic mitral annular velocity (e') measured at the interventricular-septal annulus accurately reflect left ventricular longitudinal myocardial relaxation compared to lateral annulus measurements?
Cross-Sectional (n=47)
No
Does early diastolic mitral annular velocity (e') measured at the interventricular-septal annulus accurately reflect left ventricular longitudinal myocardial relaxation compared to lateral annulus measurements?
Effect estimate: r=0.90
Absolute Event Rate: 0.9% vs 0.75%
p-value: p=<0.001
Early diastolic mitral annular velocity measured at the interventricular septum (IS-e') is a more accurate reflection of LV longitudinal myocardial relaxation and diastolic function than lateral annulus measurements.
Septal e' may better reflect longitudinal relaxation than lateral; leaves open whether it should be prioritized in diastolic evaluation.
AIMS: Early diastolic mitral annular velocity (e') obtained by tissue Doppler imaging (TDI) is widely used to evaluate left ventricular (LV) diastolic function based on the assumption that it reflects myocardial relaxation in the long-axis direction. In this study, we aimed to determine whether or not e' truly reflects early diastolic longitudinal myocardial relaxation, and which is the most useful for evaluating LV diastolic function among e' measured at the interventricular-septal annulus (IS-e'), that measured at the lateral annulus (LW-e') or their mean value (M-e'). METHODS AND RESULTS: IS-e', LW-e', and M-e' were measured using colour TDI in 15 patients with hypertrophic cardiomyopathy, 13 patients with hypertension, and 19 control subjects. Using two-dimensional speckle-tracking imaging, early diastolic myocardial strain rates (SR(E)) were measured for the IS (IS-SR(E)), LW (LW-SR(E)), and entire LV myocardium (G-SR(E)). IS-e' was excellently correlated with IS-SR(E) (r = 0.90, P < 0.001); the correlation was better than that between LW-e' and LW-SR(E) (r = 0.75, P < 0.001). IS-e' and M-e' were well correlated with G-SR(E) (r = 0.88, P < 0.001 and r = 0.86, P< 0.001, respectively) and with LV early diastolic flow propagation velocity (FPV) (r = 0.77, P < 0.001 and r = 0.78, P < 0.001, respectively). The correlations of LW-e' to G-SR(E) (r = 0.80, P < 0.001) and FPV (r = 0.75, P < 0.001) did not reach this level. CONCLUSION: IS-e' well reflected LV longitudinal myocardial relaxation and LV diastolic function, and was found to be more useful in evaluating LV diastolic function than LW-e'.
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Okada et al. (2011) conducted a cross-sectional in Hypertrophic cardiomyopathy, hypertension, and healthy controls (n=47). Interventricular septal annulus early diastolic velocity (IS-e') vs. Lateral annulus early diastolic velocity (LW-e') was evaluated on Correlation with early diastolic myocardial strain rate (SRE) (r=0.90, p=<0.001). Septal early diastolic mitral annular velocity excellently correlated with septal strain rate (r=0.90, p<0.001), reflecting left ventricular relaxation better than lateral annulus measurements.
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