Abstract 16464: Single Beat Determination of Measurements of Echocardiographic Left Ventricular Diastolic Parameters in Patients With Atrial Fibrillation
Background: In patients with atrial fibrillation (AF), echocardiographic left ventricular (LV) systolic parameters measured at the single beat, of which the ratio of preceding RR (RR1)/pre-preceding RR (RR2) = 1, well correlate with average values over multiple cardiac beats. LV diastolic function can also be successfully estimated by using the multiple-beat average values, which, however, cannot easily be applied for the clinical practice. We thus determined the minimum number of the beats to be measured for the estimation of LV diastolic function in patients with AF.
Methods: In 44 patients with AF, RR interval (RR0), RR1, RR2, RR3 (3 beats prior RR interval), early-diastolic inflow velocity (E), mitral annular systolic (s’) and early-diastolic (e’) velocities, and E-wave deceleration time (DT) were measured for 20 cardiac beats. For the echocardiographic parameters, mean values of 20 cardiac beats were used as the standards.
Results: Because E and e’ positively correlated with RR0 only within the RR0 range < 600ms and DT did only within the RR0 range < 700ms, these cardiac beats were excluded from the measurements. After the exclusion, these diastolic parameters did not correlate with RR0, RR0/RR1, RR1, RR1/RR2, RR2, RR2/RR3, nor RR3 in almost all the individual patients. Among all the patients, coefficients of variation of diastolic parameters (9±4% for e’, 6±4% for E, and 10±4% for DT) were significantly lower than that of s’ (14±11%). The correlations of diastolic parameters measured at randomly-selected single beat with the standards [intraclass correlation coefficient (ICC): 0.95 for e’, 0.93 for E, and 0.86 for DT] were not inferior to those measured at the beat in which RR1/RR2=1 (ICC: 0.97 for e’, 0.94 for E, and 0.82 for DT), and comparable to that of s’ measured at RR1/RR2=1 (ICC: 0.95).
Conclusion: After excluding cardiac beats with RR0 < 600ms for the measurements of E and e’, and RR0 < 700ms for DT, there were no relationships between parameters of cardiac cycle length and values of LV diastolic parameters, and these diastolic parameters less varied among cardiac beats than systolic parameters in patients with AF. Single beat determination should be recommended in measuring echocardiographic LV diastolic parameters in AF patients.
Author Disclosures: S. Yamada: None. A. Ichikawa: None. H. Iwano: None. K. Okada: None. S. Yokoyama: None. H. Nishino: None. M. Nakabachi: None. A. Abe: None. T. Hayashi: None. D. Murai: None. S. Kaga: None. T. Mikami: None. H. Tsutsui: Research Grant; Modest; Tanabe Mitsubishi, Daiichi-Sankyo, Takeda, Boehringer-Ingelheim, Bayer, Sanofi. Honoraria; Modest; Boehringer-Ingelheim, Bayer, BMS, Takeda. Honoraria; Significant; MSD, Tanabe-Mitsubishi, Daiichi-Sankyo, Teijin.
- © 2016 by American Heart Association, Inc.