Document Detail


Clinical utility of single-beat E/e' obtained by simultaneous recording of flow and tissue Doppler velocities in atrial fibrillation with preserved systolic function.
MedLine Citation:
PMID:  19833302     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: We evaluated the usefulness of the ratio of the early diastolic transmitral flow velocity (E) to the mitral annular velocity (e') calculated from simultaneously recorded E and e' in atrial fibrillation (AF). BACKGROUND: The ratio of the E to the e' (E/e') has been reported as a useful index even in AF patients. However, E and e' were measured during different beats in the previous studies. METHODS: Fifty-six AF patients with preserved systolic function (mean age 66 +/- 11 years) underwent routine echocardiographic study. The E/e' was calculated from the E and e' simultaneously recorded by the dual Doppler echocardiography. A single-beat E/e' was calculated from simultaneously recorded E and e' when the preceding RR interval/pre-preceding RR interval = 1. Brain natriuretic peptide (BNP) levels were also examined. Twenty-one patients underwent simultaneous pulmonary artery catheterization. RESULTS: The single-beat lateral E/e' correlated with pulmonary capillary wedge pressure (PCWP) (r = 0.74, p < 0.001). The single-beat lateral E/e' of >or=11 could predict elevated PCWP (>or=15 mm Hg) with a sensitivity of 90% and a specificity of 90%. The single-beat lateral E/e' also correlated well with the log BNP concentration. The single-beat lateral E/e' of >or=9.2 predicted a plasma BNP level of >or=200 pg/ml with 88% sensitivity and 84% specificity. CONCLUSIONS: The single-beat lateral E/e' correlated with plasma BNP level and PCWP in AF patients with preserved systolic function. In addition, the single-beat lateral E/e' (>or=11) was a good predictor of elevated PCWP (>or=15 mm Hg). Dual Doppler echocardiography offers an advantage of providing the single-beat lateral E/e' correctly even in AF patients, for the evaluation of left ventricular diastolic function.
Authors:
Kenya Kusunose; Hirotsugu Yamada; Susumu Nishio; Noriko Tomita; Toshiyuki Niki; Koji Yamaguchi; Kunihiko Koshiba; Shusuke Yagi; Yoshio Taketani; Takashi Iwase; Takeshi Soeki; Tetsuzo Wakatsuki; Masashi Akaike; Masataka Sata
Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  JACC. Cardiovascular imaging     Volume:  2     ISSN:  1876-7591     ISO Abbreviation:  JACC Cardiovasc Imaging     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-10-16     Completed Date:  2010-01-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101467978     Medline TA:  JACC Cardiovasc Imaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1147-56     Citation Subset:  IM    
Affiliation:
Department of Cardiovascular Medicine, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Atrial Fibrillation / physiopathology,  ultrasonography*
Biological Markers / blood
Catheterization, Swan-Ganz
Coronary Circulation*
Diastole
Echocardiography, Doppler, Color*
Echocardiography, Doppler, Pulsed*
Female
Heart Rate
Humans
Linear Models
Male
Middle Aged
Mitral Valve / physiopathology,  ultrasonography*
Natriuretic Peptide, Brain / blood
Predictive Value of Tests
Pulmonary Wedge Pressure
Sensitivity and Specificity
Systole
Ventricular Function, Left*
Chemical
Reg. No./Substance:
0/Biological Markers; 114471-18-0/Natriuretic Peptide, Brain
Comments/Corrections
Comment In:
JACC Cardiovasc Imaging. 2009 Oct;2(10):1157-8   [PMID:  19833303 ]

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