Document Detail


Utility of Doppler echocardiography and tissue Doppler imaging in the estimation of diastolic function in heart failure with normal ejection fraction: a comparative Doppler-conductance catheterization study.
MedLine Citation:
PMID:  17646587     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Various conventional and tissue Doppler echocardiographic indexes were compared with pressure-volume loop analysis to assess their accuracy in detecting left ventricular (LV) diastolic dysfunction in patients with heart failure with normal ejection fraction (HFNEF). METHODS AND RESULTS: Diastolic dysfunction was confirmed by pressure-volume loop analysis obtained by conductance catheter in 43 patients (19 men) with HFNEF. Their Doppler indexes were compared with those of 12 control patients without heart failure symptoms and with normal ejection fraction. Invasively measured indexes for diastolic relaxation (tau, dP/dt(min)), LV end-diastolic pressure, and LV end-diastolic pressure-volume relationship (stiffness, b [dP/dV], and stiffness constant, beta) were correlated with several conventional mitral flow and tissue Doppler imaging indexes. Conventional Doppler indexes correlated moderately with the degree of LV relaxation index, tau (E/A: r=-0.36, P=0.013; isovolumic relaxation time: r=0.31, P=0.040) and b (deceleration time: r=0.39, P=0.012) but not with beta, in contrast to the tissue Doppler imaging indexes E'/A'(lateral) (r=-0.37, P=0.008) and E/E'(lateral) (r=0.53, P<0.001). Diastolic dysfunction was detected in 70% of the HFNEF patients by mitral flow Doppler but in 81% and 86% by E'/A'(lateral), and E/E'(lateral), respectively. CONCLUSIONS: Of all echocardiographic parameters investigated, the LV filling index E/E'(lateral) was identified as the best index to detect diastolic dysfunction in HFNEF in which the diagnosis of diastolic dysfunction was confirmed by conductance catheter analysis. We recommend its use as an essential tool for noninvasive diagnostics of diastolic function in patients with HFNEF.
Authors:
Mario Kasner; Dirk Westermann; Paul Steendijk; Regina Gaub; Ursula Wilkenshoff; Kerstin Weitmann; Wolfgang Hoffmann; Wolfgang Poller; Heinz-Peter Schultheiss; Matthias Pauschinger; Carsten Tschöpe
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2007-07-23
Journal Detail:
Title:  Circulation     Volume:  116     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2007 Aug 
Date Detail:
Created Date:  2007-08-07     Completed Date:  2007-08-28     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  637-47     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiology and Pneumology, Charité-University Medicine Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12200 Berlin, Germany.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Blood Flow Velocity / physiology
Diastole / physiology*
Echocardiography, Doppler / methods*
Female
Heart Catheterization / methods*
Heart Failure / physiopathology,  ultrasonography*
Humans
Male
Middle Aged
Mitral Valve / physiology,  ultrasonography
Stroke Volume / physiology*
Ventricular Dysfunction, Left / physiopathology,  ultrasonography
Comments/Corrections
Comment In:
Circulation. 2007 Aug 7;116(6):591-3   [PMID:  17679627 ]

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


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