Relation Between Left Ventricular Diastolic Function and Haemodynamics Assessed by Pulsed Doppler Echocardiography in Patients with Dilated Cardiomyopathy

To determine whather a relationship exists, between left ventricular diastolic function and haemodynamics, Doppler indexes of left ventricular diastolic function in 19 patients with dilated cardiomyopathy and right heart pressures were measured. Patients were classified into two groups according to functional class. Group I consisted of 11 patients in NYHA functional Class I or II; group II included 8 patients in functional class III or IV. Left ventricular dimensions, ejection fraction, fractional shortening, left ventricular mass and mass index, E and A velocity, E/A, E/A integral, atrial filling fraction, isovolumic relaxation time (IRT) were computed from pulsed-wave Doppler and M-mode echocardiography. No difference was observed between groups in regard to age, heart rate and M-mode-echocardiogram-derived indexes of systolic function. Mean peak early velocity (E velocity) was higher, atrial velocity (A velocity) was lower, the ratio of early to late velocity (E/A) was higher in group II than in group I (p<0.05). Mean right atrial, pulmonary artery and pulmonary capillary wedge (PCWMP) pressures were measured higher in group II than in group I (p<0.05). A correlation (r=0.68) was observed between mean pulmonary artery pressure and E/A ratio in all patients. Mean PCWP also correlated significantly with E/A ratio in 6 patients with severe mitral regurgitation (r=0.86). In conclusion, the higher the E/A ratio in patients with dilated cardiomyopathy, the more severe heart failure and mitral regurgitation may be considered.