Document Detail


Derivation and validation of a diagnostic model for the evaluation of left ventricular filling pressures and diastolic function using mitral annulus tissue Doppler imaging.
MedLine Citation:
PMID:  18440343     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Several modalities to diagnose diastolic dysfunction by transthoracic echocardiography (TTE) exist. We compared the ratio of early mitral filling velocity (E) to early diastolic velocity by tissue Doppler imaging at the medial (E/E'm) and the lateral (E/E'l) mitral annulus and developed a model to diagnose elevated left ventricular end-diastolic pressure (LVEDP). METHODS: Sixty patients underwent same-day cardiac catheterization and TTE. Left ventricular end-diastolic pressure was recorded in addition to TTE data, including left atrial area (LAA), E/E'm, and E/E'l. An LVEDP >15 mm Hg was considered to be elevated and diagnostic of diastolic dysfunction. RESULTS: E/E'm had a significantly higher correlation (r = 0.68, P < .001) than did E/E'l (r = 0.46, P < .001). By univariate analysis, LAA >18.75 cm(2), E/E'l >11.2, and E/E'm >15.75 were found to be significant predictors of high LV filling pressure. By multivariate binary logistic regression model analysis, only E/E'm and LAA were independent predictors of LVEDP >15 mm Hg. The presence of 1 variable had a sensitivity of 95% and a specificity of 43.4%, whereas the presence of 2 variables had a sensitivity of 76.2% and a specificity of 100%. CONCLUSIONS: Use of a diagnostic model based on easily derived measurements such as E/E'm and LAA was a powerful noninvasive diagnostic modality for elevated LVEDP. Measurement of the mitral annulus velocity by tissue Doppler imaging at the medial aspect of the mitral valve appeared to be superior to that at the lateral aspect.
Authors:
Roque B Arteaga; Haitham Hreybe; Dineshkumar Patel; Carolyn Landolfo
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Publication Detail:
Type:  Comparative Study; Journal Article; Validation Studies     Date:  2008-02-19
Journal Detail:
Title:  American heart journal     Volume:  155     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-04-28     Completed Date:  2008-05-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  924-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, Section of Cardiology, Medical College of Georgia, Augusta, GA, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Blood Flow Velocity
Blood Pressure / physiology*
Diastole / physiology
Female
Heart Catheterization
Humans
Male
Middle Aged
Mitral Valve / ultrasonography*
Sensitivity and Specificity
Ultrasonics*
Ventricular Dysfunction, Left / physiopathology,  ultrasonography*
Ventricular Function, Left / physiology
Ventricular Pressure / physiology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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