Doppler Tissue Imaging: A Noninvasive Technique for Estimation of Left Ventricular End-diastolic Pressure

Recent observations suggest that the early diastolic velocity of the mitral annulus (Ea) is an index of left ventricular relaxation that is less influenced by left ventricular filling pressure. This study sought to eletermine the applicability of the combineel information obtained from transmitral Doppler flow and Doppler tissue imaging (DTI) for esrimaring left ventricular end-diastolic pressure (LVEDP). We included 85 patients who had coronary artery disease (CAD) in coronary angiography. Standard Doppler variables (E velocity, A velocity, E/A ratio, deceleration time and DTI variables (Early diastolic mitral annulus velocity [Ea], Iate diastolic velocity [Aa], and ratio of trans-mitral E velocity to mitral annulus Ea velocity) were assessed for their accuracy in predicting L VEDP> 15ınmHg. The ratio of E velocity to the other variables derived from the diastolic annular velocity did not provide better res ult than E/Ea. S ignificant corre lat ion was observed between the E/Ea ratio and L VEDP (r= 0.62 p lO detected LVEDP> l5 mmHg, with sensitivitiy of 85% and a specificitiy of 77%.
CONCLUSION
Mitral E velocity, corrected for the influence of relaxation (i.e E/ Ea ratio), relates to L VEDP in CAD patients and m ay be u sed to estimate LV filling pressure.