Estimation of Left Ventricular end-diastolic Pressure by color M-mode Doppler Echocardiography and Tissue Doppler Imaging

The aim of this study is to estimate the left ventricular end diastolic pressure (LVEDP) noninvasively by tissue Doppler imaging and color M-mode echocardiography. Material and method: Three group of patients angiographically proven to be free of significant coronary artery lesions (<40 % stenosis) with LVEDP < 10 mmHg (Group A: n: 24 , 16 males, mean age ± SD: 55 ± 13 years); LVEDP= 10-15 mmHg (Group B: n:21, 17 males, mean age± SD: 56 ± 11 years); and L VEDP > 15 mmHg (Group:C: n:35, 20 males mean age ± SD: 58 ± 9 years) were studied. Using an Aloka SSD 2200 echocardiography device tissue Doppler imaging of the lateral mitral annulus and color M-mode imagings of the mitral valve in apical 4-chamber view were obtained. Early and Iate diastolic velocities (Em, Am), Em deceleration time (EmDT), Am time (Am-t), mitral propagation velocity time delay (VpDT) were measured in every patient.
RESULTS
In group A sensitivity and specificity for EmDT being ?100 msec, Am-t?90 msec, Em/Am?1, and V pDT? 45msec were found to be 0.57 and 0.89, 0.66 and 0.88, 0.86 and 0.92, 0.73 and 0.89; respectively. In Group B sensitivicity and specificity for EmDT being between 100-120 msec, Am-t between 90-110 msec, Em/Am between 1-0.5 and VpDT between 45-60 msec were found to be 0. 57 and 0.84, 0.69 and 0.82, 0.66 and 0.75, 0.55 and 0.83, respectively. In Group C sensitivicity and specifity for EmDT being > 120 msec, Am-t > 110 msec, Em/Am <0.5 and VpDT >60 msec were found to be 0.88 and 0.81, 0.71 and 0.80, 0.86 and 0.72, 0.78 and 0.86; respectively.
CONCLUSION
EmDT, Am-t. Em/Am and VpDT measurements obtained noninvasively by left ventricular tissue Doppler imaging and mitral flow propagation velocity were found meaningful in estimatiny LVEDP.