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ȣ - 480132 167 |
The Preload Independence of A New Parameter to evaluate Left Ventricular Diastolic Function |
Department of Cardiology¹ and Nephrology², Ajou University School of Medicine, Suwon, Korea |
Sang-Yong Yoo¹, Eun-Ah Choi¹, Jung-Hyun Choi¹, Heungsoo Kim² , Gyu-Tae Shin² , So-Yeon Choi¹, Myeong-Ho Yoon¹, Gyo-Seung Hwang¹, Seung-Jea Tahk¹, Joon-Han Shin¹ |
BACKGROUND : The time interval between the onsets of mitral inflow and mitral annulus velocity(TE'-E) has been proposed as a new index representing left ventricular(LV) relaxation and related to LV filling pressure. This index has been reported as a preload independent parameter in experimental canine model. The impact of preload on this index, however, has not been studied in human. METHODS : Twenty-nine patients(18 men, mean 51±15 years old) with end-stage renal disease underwent echocardiography immediately before and after hemodialysis(HD). The complete two-dimensional and Doppler echocardiography including early(E) and late(A) transmitral inflow velocities were measured. Mitral annulus velocities(E’) by Doppler tissue imaging(DTI) and flow propagation velocity(Vp) by color M-mode were also measured. The Time intervals between peak of R wave and onset of mitral E velocity and between peak R wave and onset of E' at septal, lateral, anterior, and inferior areas of the mitral annulus were measured. TE'-E were calculated by correcting for the heart rate(using the √R-R interval). RESULTS : The mean ejection fraction was 64±15 %. Average weight reduction by HD was 3±1 kg. The dimensions of LV end-diastole, left atrium and inferior vena cava were reduced significantly as 2±3, 2±5 , and 4±5 mm, respectively(p<0.001). The table shows the changes of Doppler-Echo parameters after HD. CONCLUSIONS : We conclude that a new parameter for diastolic function, time interval between the onsets of mitral inflow and mitral annulus velocity appears to be preload-independent in human.
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Pre-HD |
Post-HD |
p |
E (cm/sec) |
102.7±28.2 |
71.1±24.9 |
<0.001 |
E/A ratio |
1.2±0.6 |
1.0±0.8 |
0.004 |
E’ (cm/sec) |
10.3±3.5 |
9.2±3.7 |
0.005 |
Vp (cm/sec) |
49.7±16.2 |
43.2±15.0 |
0.036 |
E/E’ |
11.3±5.8 |
9.1±5.8 |
0.001 |
E/Vp |
2.2±0.8 |
1.8±0.7 |
0.02 |
TE'-E (msec) |
0.9±0.8 |
0.7±1.3 |
NS |
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