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Incremental Value of Measuring the Time Difference Between Onset of Mitral Inflow and Onset of Early Diastolic Mitral Annulus Velocity for the Evaluation of Left Ventricular Diastolic Pressures in Patients With Normal Systolic Function and an Indeterminate E/E′

 Pil-Ki Min  ;  Jong-Won Ha  ;  Namsik Chung  ;  Seung-Yun Cho  ;  Won-Heum Shim  ;  Yangsoo Jang  ;  Se-Joong Rim  ;  Donghoon Choi  ;  Eui-Young Choi  ;  Jae-Hun Jung 
 AMERICAN JOURNAL OF CARDIOLOGY, Vol.100(2) : 326-330, 2007 
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This study sought to evaluate the incremental value of the time interval between the onset of early transmitral flow velocity (E) and the onset of early diastolic velocity (E') of the mitral annulus for the prediction of left ventricular (LV) end-diastolic pressure (EDP) in the presence of a "gray zone" value for E/E'. An E/E' ratio of 8 to 15 is classified as the "gray zone" for the estimation of LVEDP. Recently, it was suggested that prolongation of the time interval between the onset of E and E' (T(E'-E)) might indicate elevated filling pressure. Simultaneous left-sided cardiac catheterization and Doppler echocardiography were performed in 74 patients with normal systolic function. T(E'-E) was calculated as the time interval between the peak of the R wave and the onset of E' and between the peak of the R wave and the onset of E. Of the 74 patients enrolled, 55 (27 men, mean age 59 years) who had E/E' ratios of 8 to 15 were analyzed. LVEDP was elevated (>18 mm Hg) in 34 patients (62%). There was no significant difference in Doppler echocardiographic parameters and N-terminal pro-brain natriuretic peptide levels between those with normal and high LVEDP, except T(E'-E), which was significantly longer in the latter (19.0 +/- 17.8 vs 35.0 +/- 17.0 ms, p = 0.002). The receiver-operating characteristic curves for the prediction of high LVEDP showed the largest area under the curve (0.760) for T(E'-E). In multivariate analysis, T(E'-E) added significant information to the other parameters in the prediction of high LVEDP (p = 0.029). In conclusion, T(E'-E) may have an incremental value in the estimation of LVEDP in patients with normal systolic function and indeterminate E/E' ratios.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Min, Pil Ki(민필기) ORCID logo https://orcid.org/0000-0001-7033-7651
Shim, Won Heum(심원흠)
Rim, Se Joong(임세중) ORCID logo https://orcid.org/0000-0002-7631-5581
Jang, Yang Soo(장양수) ORCID logo https://orcid.org/0000-0002-2169-3112
Chung, Nam Sik(정남식)
Cho, Seung Yun(조승연)
Choi, Dong Hoon(최동훈) ORCID logo https://orcid.org/0000-0002-2009-9760
Choi, Eui Young(최의영) ORCID logo https://orcid.org/0000-0003-3732-0190
Ha, Jong Won(하종원) ORCID logo https://orcid.org/0000-0002-8260-2958
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