Left Ventricular Diastolic Function Assessment Using Time Differences Between Mitral Annular Velocities and Transmitral Inflow Velocities in Patients with Heart Failure

BackgroundEvaluation of left ventricular (LV) diastolic function is important in clinical echocardiography. The relationship between mitral annular velocities and transmitral inflow velocities provide additional information about LV filling and diastolic function. This study evaluates the relationships of time intervals between peaks E of mitral inflow velocities and E’ of mitral annular velocities, and peaks A and A’ in patients with heart failure (HF).MethodsEighty patients with HF and 50 age- and gender-matched normal healthy subjects were prospectively recruited and underwent full echocardiograms. The following time intervals were measured: (1) from the onset of R-wave on the ECG to the peak of E-wave on the transmitral flow (TMF) (R-pE); (2) from R to peak of E’-wave on the LV lateral wall of tissue Doppler imaging (TDI) (R-pE’); (3) from onset of P-wave to peak of A-wave on the TMF (P-pA); and (4) from onset of P-wave to peak of A’-wave (P-pA’) of TDI. Early-diastolic temporal discordance (EDTD) and late-diastolic temporal discordance (LDTD) were calculated as the difference between the time intervals (R-E) and (R-E’), (P-pA) and (P-p A’).ResultsEDTD significantly decreased in patients with HF compared with normal subjects (18.0 ± 54.1 ms vs. 28.0 ± 33.5 ms, P < 0.05). There was also a significant decrease in LDTD in HF patients compared with normal subjects (19.6 ± 23.5 ms vs. 34.8 ± 20.6; P < 0.05).ConclusionsEDTD and LDTD decreased in patients with heart failure, and they may be useful tools in identifying abnormal LV relaxation and left atrial contraction for LV diastolic function.