Method
Differences of Lateral and Septal Mitral Annulus Velocity by Tissue Doppler Imaging in the Evaluation of Left Ventricular Diastolic Function

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Left ventricular diastolic dysfunction (LVDD) was investigated in 276 outpatients at a university cardiology practice by tissue Doppler imaging of mitral valve annular velocity. The well-investigated parameters of mitral inflow were used as the standard. Using septal E/Ea ratios, 62 patients (22%) had no LVDD, 44 patients (16%) had mild LVDD, 126 patients (46%) had moderate LVDD, 25 patients (9%) had severe LVDD, and 19 patients (7%) had indeterminate LVDD. Using lateral E/Ea ratios, 131 patients (48%) had no LVDD, 40 patients (14%) had mild LVDD, 62 patients (22%) had moderate LVDD, 9 patients (3%) had severe LVDD, and 12 patients (13%) had indeterminate LVDD. In conclusion, the use of septal tissue Doppler imaging tends to overestimate the severity of LVDD compared with the use of lateral tissue Doppler imaging.

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Methods and Results

We analyzed 2-dimensional and Doppler echocardiograms from 276 outpatients (151 men, 125 women; mean age 56 years) at a university private practice in a 6-month period. Complete transthoracic echocardiograms and Doppler studies were performed on all patients for clinical indications by 1 of 3 experienced sonographers using Hewlett-Packard Sonos 5500 ultrasound machines (Philips Medical Systems, Andover, Massachusetts).

The left atrial dimension was measured at ventricular end-systole in the

Discussion

TDI is a reproducible and feasible means of assessing LV mitral annular velocities. There is no general consensus as to which mitral annular velocity (septal, lateral, or the mean of septal and lateral) is more accurate for assessing LVDD.

The present study showed that the severity of LVDD using the septal, lateral, and mean mitral annular velocities correlated well with left atrial dimensions. As the degree of LVDD became more severe, left atrial size and volume increased. There was no

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