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Vortices are formed during the acceleration phases of the early and atrial filling waves.
We assessed diastolic function by conventional pulsed-wave spectral Doppler analysis of mitral valve inflow patterns (early [E] and late [A] filling waves).
The peak velocities of early (E) and late (A) filling waves, and E wave deceleration rate were measured.
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A decreased ratio of peak flow velocity of the early rapid diastolic filling wave to peak flow velocity of the late diastolic filling wave (E/A ratio) in immunized rats indicates diastolic dysfunction (Figure 3 C).
A, late transmitral filling wave; E, early transmitral filling wave; Ea, medial mitral annulus wave; LVEF, left ventricular ejection fraction.
E/A, ratio of transmitral early filling wave velocity to atrial filling wave velocity; Ea, myocardial early diastolic velocity by tissue Doppler at lateral mitral annulus; E/Ea, ratio of transmitral early diastolic velocity to myocardial early diastolic velocity of lateral mitral annulus by tissue Doppler.
LV, left ventricular; EDD, end-diastolic dimension; ESD, end-systolic dimension; FS, fractional shortening; EDV, end-diastolic volume; ESV, end-systolic volume; EF, ejection fraction; E, early filling wave; A, late filling wave; E/A ratio, Doppler ratio of early to late transmitral flow velocity; Wt, weight; CO, cardiac output.
The following pulsed Doppler measurements of the mitral flow were obtained: maximum early transmitral flow velocity in diastole (E), maximum late transmitral velocity flow in diastole (A), the deceleration time of the early mitral filling wave (DT), and isovolumic relaxation time (IVRT).
The second finding of this study was also not astonishing: Sturgess et al. found only a weak relationship between the pulmonary artery occlusion pressure and the ratio of the early filling wave velocity at the level of the mitral valve (E) and the analogue myocardial velocity assessed at the mitral annulus with tissue Doppler imaging (E').
Comparison of the functional parameters showed a prolonged deceleration time (DT) (p < 0.05), increased mitral inflow late filling wave (p < 0.001), decreased mitral inflow E/A ratio (p < 0.005), and decreased peak annular early diastolic velocity of the lateral mitral annulus in tissue Doppler imaging (p < 0.001) among the patients with LVDD.
E wave = early filling velocity wave; E' = early diastolic wave; LV = left ventricular; TDI = tissue Doppler imaging.
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