Abstract 2695: A New Doppler Index For Assessment Of Left Ventricular Diastolic Function: Ratio Of Early Diastolic Transmitral Inflow Velocity To Late Diastolic Mitral Annular Tissue Velocity In Patients With Coronary Artery Disease
Background: Late diastolic period is related with left ventricular stiffness. Our hypothesis was that the combination of both early and late diastolic parameters may predict LV end-diastolic pressure (LVEDP) more accurately than the previous index, the ratio of early diastolic transmitral inflow velocity to early diastolic mitral annular tissue velocity (E/e’) which uses only early diastolic parameters.
Methods: LVEDP and coronary angiogram (CAG) were obtained within 2-h after standard echocardiography with tissue Doppler imaging without preload change. Medial and lateral mitral annular tissue velocities were obtained and mean value was used for analysis. Patients with normal CAG were excluded.
Results: A total of 50 patients (30 men; mean ages, 63.2 ± 9.8 years) were enrolled. LV ejection fraction was 68 ± 11 %. E/e’ ratio showed positive correlation with LVEDP (r = 0.406, p = 0.003). The ratio of E velocity to late diastolic mitral annular tissue velocity (E/a’) showed stronger positive correlation with LVEDP (r = 0.502, p < 0.001) compared to E/e’ ratio (Figure 1⇓). The ratio of late diastolic transmitral inflow velocity to a’ velocity (A/a’) did not show significant correlation with LVEDP (r = 0.233, p = 0.104). In ROC curve analysis, an E/a’ ratio > 8 was the optimal cut-off value for predicting LVEDP > 15mmHg with a sensitivity of 77% and specificity of 76% (Figure 2⇓).
Conclusion: In this study, E/a’ ratio which uses both early and late diastolic Doppler parameters, showed better correlation with LVEDP compared to E/e’ ratio in patients with coronary artery disease. E/a’ ratio may be used as an alternative index for the assessment of diastolic function.