Clinical Application of Pulsed Doppler Tissue Imaging for Assessing Abnormal Left Ventricular Relaxation
Section snippets
Study Population
We performed routine echocardiography, left cardiac catheterization, and coronary angiography in 100 consecutive Japanese patients with suspected cardiovascular disease based on clinical symptoms such as chest pain and dyspnea, abnormal findings in the electrocardiogram, cardiomegaly in the chest radiograph, and heart murmurs during auscultation. In 50 (32 men and 18 women, age range 39 to 72 years, mean 54 ± 9) of the 100 patients, LV pressure curves were recorded using a high-fidelity
Clinical Data
The group of patients with heart disease and the control group did not differ significantly as to age or heart rate (Table 1). The 38 patients were classified into 2 groups with respect to transmitral flow velocity patterns. Nine patients (5 with dilated cardiomyopathy, 2 with ischemic cardiomyopathy, and 2 with cardiac amyloidosis) exhibited a pseudonormalized pattern; that is, the ratio of the peak velocity of the atrial systolic wave to the peak velocity of the early diastolic wave (A/E) was
Discussion
To evaluate the diastolic function of the LV accurately, it is necessary to assess LV relaxation at the isovolumic diastole as well as LV filling, which, in turn, is determined by the relationship between LV volume and pressure after opening of the mitral valve.[1] LV relaxation abnormalities sometimes appear before the occurrence of LV systolic dysfunction.1, 2, 3 Moreover, these abnormalities have been reported to develop with age even in healthy subjects.20, 21 The time constant calculated
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