Value of tissue doppler echocardiography in assessing left ventricular diastolic dysfunction

Abstract AR

Objectives : To assess the value of the tissue Doppler echocadiography (TDE) in diagnosing left ventricular diastolic dysfunction (LVDD), especially in the existence of pseudonormalization of the A/E ratio and isovolumic relaxation time (IVRT).

Methods: Fifty-two patients from the outpatient cardiology clinic of Al Mouassat Hospital were studied by echocardiography between February and July 2003.

They were divided into two groups.

The first, Group A, contained 28 patients with a history of uncontrolled systemic hypertension for more than six months, aortic valve stenosis, or ischemic heart disease proven by angiography.

All these patients had at least one of the following echocardiographic signs suggesting LVDD: A/E > 2, IVRT>90 ms, concentric left ventricular hypertrophy, or enlargement of the AC reversed wave of the pulmonary vein flow spectrum.

The second, Group B, contained 24 patients (less than 40 years old).

None of this group had any sign of LVDD either by echocardiography or clinically.

All the patients had echocardiography with the following measurements: LA diameter, Aortic root diameter (AoD), E wave, A wave, A/E ratio.

The E wave of the mitral valve annulus(Ea) and the A wave of the mitral valve annulus (Aa)were both measured by TDE, andAa/Ea ratio was caluclate in all patients.

Result : The AaJEa ratio was higher than one in all patients of Group A, even in those cases with pseudonormalization of the A/E ratio measured by traditional Doppler.

TheAa/Ea ratio was less than one in all patients of Group B.

Conclythion: These results strongly support the usefulness of TDE of the mitral valve annulus in diagnosing LVDD even when there is pseudonormalization of the A/E ratio measured by traditional Doppler.