Document Detail

The mitral annular middiastolic velocity curve: functional correlates and clinical significance in patients with left ventricular hypertrophy.
MedLine Citation:
PMID:  17658726     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Little is known regarding the tissue Doppler characteristics and clinical significance of mitral annular motion during diastasis (L' wave). METHODS: In consecutive patients with left ventricular hypertrophy and normal ejection fraction, standard Doppler and Doppler tissue imaging were performed. Patients were followed up for heart failure (HF) hospitalization. RESULTS: Of 177 patients, 53 (30%) had an L', detected most frequently at the lateral mitral annulus, whereas 35 (20%) had middiastolic transmitral flow (L wave), which almost invariably coexisted with the L'. The L' predicted increased left ventricular filling pressure with 74% sensitivity and 82% specificity, and increased risk of future HF (hazard ratio 3.9 [P = .030]), even after adjusting for baseline clinical differences (hazard ratio 6.5 [P = .024]). When associated with an L wave, HF risk increased further. CONCLUSIONS: Middiastolic annular motion, detectable in almost a third of patients with left ventricular hypertrophy, may be an early marker of diastolic dysfunction and a prognostic marker for HF.
Carolyn S P Lam; Lin Han; Jae K Oh; Hong Yang; Lieng H Ling
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Publication Detail:
Type:  Journal Article     Date:  2007-07-20
Journal Detail:
Title:  Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography     Volume:  21     ISSN:  1097-6795     ISO Abbreviation:  J Am Soc Echocardiogr     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-02-11     Completed Date:  2008-03-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8801388     Medline TA:  J Am Soc Echocardiogr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  165-70     Citation Subset:  IM    
Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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MeSH Terms
Blood Flow Velocity
Cohort Studies
Confidence Intervals
Diastole / physiology
Echocardiography, Doppler, Pulsed*
Follow-Up Studies
Heart Failure / physiopathology*
Hypertrophy, Left Ventricular / physiopathology,  ultrasonography*
Middle Aged
Mitral Valve / physiopathology*,  ultrasonography
Odds Ratio
Proportional Hazards Models
Prospective Studies
Risk Assessment
Severity of Illness Index
Stroke Volume / physiology*
Ventricular Dysfunction, Left / physiopathology,  ultrasonography*

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