Korean Circ J.  2004 Nov;34(11):1082-1089. 10.4070/kcj.2004.34.11.1082.

The Usefulness of Color M-mode Doppler Echocardiographic Indices in the Assessment of Left Ventricular Diastolic Function

• Yun KH
• Kang DG
• Kim KH
• Hong SN
• Lim SY
• Lee YS
• Lee SH
• Hong YJ
• Kim JH
• Ahn YK
• Jeong MH
• Cho JG
• Park JC
• Kim NH
• Oh SK
• Jeong JW
• Kang JC

• KMID: 2227181
• DOI: http://doi.org/10.4070/kcj.2004.34.11.1082

Abstract

BACKGROUND AND OBJECTIVES
Early color M-mode Doppler flow propagation (Vp) has been used to distinguish pseudonormal from normal diastolic filling patterns. However, the role of other indices, including the late diastolic propagation velocity (Ap) and time delay of mitral flow propagation (VpTD and ApTD), is not clear.
SUBJECTS AND METHODS
Doppler echocardiographic examinations were performed in 89 patients (60.6+/-9.9 years, male 59.6%), with an ejection fraction > or =40%, who were admitted for diagnostic coronary angiography. The clinical diagnoses on admission were stable angina (41.6%), unstable angina (30.3%), old myocardial infarction (24.7%) and atypical chest pain (3.3%) The diastolic filling patterns, as confirmed by mitral inflow and pulmonary venous flow, were compared with the Ap, VpTD and ApTD indices using color M-mode Doppler echocardiography.
RESULTS
The age, left ventricular ejection fraction, left ventricular end diastolic and end systolic dimensions, the left atrial size, and the E'and A'velocities of the mitral annulus tissue Doppler were significantly different between patients with normal and abnormal diastolic filling patterns. In patients with normal filling, impaired relaxation and pseudonormalized filling patterns, the VpTD were 63.1+/-14.9, 85.2+/-25.5 and 107.8+/-36.8 ms (p<0.001), the E/Vp were 1.3+/-0.4, 1.6+/-0.6 and 3.1+/-0.7 (p<0.001), and the E/VpTD were 1.2+/-0.5, 0.7+/-0.2 and 0.9+/-0.4 (p<0.001), respectively. The Ap and ApTD showed significant differences between patients with normal and pseudonormalized filling patterns (Ap 58.3+/-23.5 vs. 36.2+/-15.1, p=0.000; ApTD 47.1+/-19.5 vs. 66.7+/-22.2, p=0.001). The PVa duration, an index that depends on the left ventricular end-diastolic pressure, was the most important independent predictor for ApTD from a multiple regression analysis (R2=71.4%).
CONCLUSION
The color M-mode Doppler indices, Ap, VpTD and ApTD, are new diagnostic parameters for diastolic dysfunction.

Keyword

Echocardiography; Diastole; Heart failure

MeSH Terms

Angina, Stable
Angina, Unstable
Chest Pain
Coronary Angiography
Diagnosis
Diastole
Echocardiography*
Echocardiography, Doppler
Heart Failure
Humans
Male
Myocardial Infarction
Relaxation
Stroke Volume