© 2001 European Society of Cardiology
Letter to the Editor
1st Department of Cardiology, Evangelismos General Hospital 28 Doukissis Plakentias Street, 115 23-Amelokipi, Athens, Greece
2nd Department of Cardiology Evangelismos General Hospital 28 Doukissis Plakentias Street 115 23-Amelokipi, Athens, Greece
Study of mitral annulus motion by Doppler tissue imaging and M-mode echocardiography
We read with interest the study by Jarnet et al. [1] regarding, the comparison between Doppler tissue imaging (DTI) and mitral atrioventricular plane displacement (AVPD), recorded by M-mode echocardiography, for the assessment of left ventricular function in congestive heart failure patients. Some years ago, we assessed left ventricular diastolic filling by measuring mitral AVPD. In hypertensive patients with normal systolic function we found that diastolic mitral AVPD assessed by M-mode echocardiography can be used to estimate left ventricular diastolic filling and can detect impaired relaxation of the left ventricle [2]. In two other studies we found in patients with coronary artery disease that the ratio of the movement of the left atrioventricular plane (produced by atrial systole) to the total diastolic motion is correlated to the end-diastolic pressure of the left ventricle [3] but this ratio is dependent on left ventricular ejection fraction and heart rate [4]. Also we found that the systolic motion of mitral AVPD under dobutamine infusion is a predictor of viability of dysfunctional myocardium [5,6].
Recently, we compared DTI and mitral AVPD [7], in the assessment of left ventricular function in heart failure patients with coronary artery disease. Our methodology was different from Jarnet et al. [1]. Our patients were younger (67±12 years) and in our study pulsed Doppler DTI was performed with the sampling volume at the septal, lateral, anterior, inferior and posterior margins of the left atrioventricular plane from apical views, while in the study of Jarnet et al. [1] the sampling volume was located only in the middle of interventricular septum. Like Jarnet et al. [1], we found that during systole the maximal velocity of systolic DTI wave decreases with reduced left ventricular injection fraction (r=0.7) and that this correlation was better than the correlation between systolic AVPD and left ventricular ejection fraction (r=0.35). Jarnet et al. [1] by measuring DTI parameters showed that DTI has a similar accuracy as mitral pulse wave Doppler method in identifying diastolic heart failure patients and is superior to AVPD method. The last conclusion was similar with ours, given that we found a better correlation between mean diastolic early and late velocity ratio as assessed by DTI (r=0.5) than the early and late diastolic mitral AVPD (r=0.3) ratio, with the ratio of early and late trasmitral velocities as assessed by pulse wave Doppler.
Jarnet et al. [1], pointed out that further studies are needed to examine if their results apply to younger heart failure patients. Our study confirms that the new method (DTI) is superior from the old one (AVPD technique) also for the study of younger heart failure patients.
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* Tel.: 30-1674-5222; fax: 30-1674-5222. E-mail address: geros{at}compulink.gr (G. Filippatos)
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- Jarnet C., Mejhert M., Ring M., et al. Doppler tissue imaging in congestive heart failure patients due to diastolic and systolic dysfunction: a comparison with Doppler echocardiography and atrioventricular plane displacement technique’. Eur J Heart Failure (2000) 2:151–160.
[Abstract/Free Full Text] - Kranidis A., Kostopoulos K., Sioras E., et al. Echocardiographic assessment of left ventricular diastolic filling in hypertensive patients using the mitral valve annulus motion. J Cardiovasc Diagn Proc (1995) 12:227–232.[Web of Science]
- Kranidis A., Kostopoulos K., Margaris N., et al. Significance of echocardiographic atrioventricular plane displacement for the evaluation of left ventricular filling and end-diastolic pressure in patients with coronary artery disease. Int J Cardiac Imaging (1995) 11:185–192.[CrossRef][Web of Science][Medline]
- Kranidis A., Kostopoulos K., Filippatos G., et al. Analysis of left atrioventricular plane movement during diastole in ischemic heart disease. Jpn Heart J (1995) 36:545–556.[Medline]
- Kranidis A., Bouki T., Kostopoulos K., et al. The contribution of the left atrioventricular plane displacement during low dose dobutamine stress echocardiography in predicting recovery of left ventricular dyssynergies. Echocardiography (1996) 13:587–597.[CrossRef][Web of Science][Medline]
- Kranidis A., Filippatos G., Kappos K., Anthopoulos L. Atrioventricular plane displacement during low dose dobutamine infusion predicts recovery of left ventricular dyssynergies. Heart (1998) 80:208.
[Free Full Text] - Tsiotika T. Filippatos G. Kranidis A. et al. Study of mitral annulus motion, by Doppler tissue imaging and m-mode echocardiography, for the assessment of left ventricular systolic and diastolic function in patients with coronary artery disease. Eur Heart J 1999;20 (abstract supplement):679.
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