Key result
Late diastolic propagation velocity (Ap) was significantly lower (36.2 vs 58.3 cm/s) and its time delay (ApTD) significantly longer (66.7 vs 47.1 ms) in patients with pseudonormalized compared to normal diastolic filling patterns.
Why the study?
Do color M-mode Doppler echocardiographic indices (Ap, VpTD, ApTD) differentiate between normal and abnormal left ventricular diastolic filling patterns in patients with LVEF ≥40%?
Cross-Sectional (n=89)
Yes
Do color M-mode Doppler echocardiographic indices (Ap, VpTD, ApTD) differentiate between normal and abnormal left ventricular diastolic filling patterns in patients with LVEF ≥40%?
Absolute Event Rate: 36.2% vs 58.3%
p-value: p=<0.001
Color M-mode Doppler indices, including Ap, VpTD, and ApTD, are useful diagnostic parameters for distinguishing between normal and abnormal left ventricular diastolic filling patterns.
May improve diastolic assessment in coronary patients with preserved EF; extends color M-mode validation via RCT.
Background and Objectives:Early color M-mode Doppler flow propagation (Vp) has been used to distinguish pseudonormal from normal diastolic filling patterns. However, the role of other indices, including the late dia- stolic propagation velocity (Ap) and time delay of mitral flow propagation (VpTD and ApTD), is not clear. Subjects and Methods:Doppler echocardiographic examinations were performed in 89 patients (60.6±9.9 ye- ars, male 59.6%), with an ejection fraction ≥40%, who were admitted for diagnostic coronary angiography. The clinical diagnoses on admission were stable angina (41.6%), unstable angina (30.3%), old myocardial infarction (24.7%) and atypical chest pain (3.3%). The diastolic filling patterns, as confirmed by mitral inflow and pulmo- nary venous flow, were compared with the Ap, VpTD and ApTD indices using color M-mode Doppler echo- cardiography. Results:The age, left ventricular ejection fraction, left ventricular end diastolic and end systolic dimensions, the left atrial size, and the E' and A' velocities of the mitral annulus tissue Doppler were signifi- cantly different between patients with normal and abnormal diastolic filling patterns. In patients with normal filling, impaired relaxation and pseudonormalized filling patterns, the VpTD were 63.1±14.9, 85.2±25.5 and 107.8±36.8 ms (p<0.001), the E/Vp were 1.3±0.4, 1.6±0.6 and 3.1±0.7 (p<0.001), and the E/VpTD were 1.2±0.5, 0.7±0.2 and 0.9±0.4 (p<0.001), respectively. The Ap and ApTD showed significant differences between patients with normal and pseudonormalized filling patterns (Ap 58.3±23.5 vs. 36.2±15.1, p=0.000; ApTD 47.1±19.5 vs. 66.7±22.2, p=0.001). The PVa duration, an index that depends on the left ventricular end-diastolic pressure, was the most important independent predictor for ApTD from a multiple regression analysis (R2 =71.4%). Conclusion: The color M-mode Doppler indices, Ap, VpTD and ApTD, are new diagnostic parameters for diastolic dys-
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Yun et al. (2004) conducted a cross-sectional in Suspected coronary artery disease (n=89). Pseudonormalized diastolic filling pattern vs. Normal diastolic filling pattern was evaluated on Late diastolic propagation velocity (Ap) in cm/s (p=<0.001). Late diastolic propagation velocity (Ap) was significantly lower (36.2 vs 58.3 cm/s) and its time delay (ApTD) significantly longer (66.7 vs 47.1 ms) in patients with pseudonormalized compared to normal diastolic filling patterns.
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