The Mitral Annular Middiastolic Velocity Curve: Functional Correlates and Clinical Significance in Patients with Left Ventricular Hypertrophy

Carolyn S.P. Lam, Lin Han, Jae K. Oh, Hong Yang, Lieng H. Ling

Research output: Contribution to journalArticle

10 Scopus citations

Abstract

Background: Little is known regarding the tissue Doppler characteristics and clinical significance of mitral annular motion during diastasis (L' wave). Methods: In consecutive patients with left ventricular hypertrophy and normal ejection fraction, standard Doppler and Doppler tissue imaging were performed. Patients were followed up for heart failure (HF) hospitalization. Results: Of 177 patients, 53 (30%) had an L′, detected most frequently at the lateral mitral annulus, whereas 35 (20%) had middiastolic transmitral flow (L wave), which almost invariably coexisted with the L'. The L' predicted increased left ventricular filling pressure with 74% sensitivity and 82% specificity, and increased risk of future HF (hazard ratio 3.9 [P = .030]), even after adjusting for baseline clinical differences (hazard ratio 6.5 [P = .024]). When associated with an L wave, HF risk increased further. Conclusions: Middiastolic annular motion, detectable in almost a third of patients with left ventricular hypertrophy, may be an early marker of diastolic dysfunction and a prognostic marker for HF.

Original languageEnglish (US)
Pages (from-to)165-170
Number of pages6
JournalJournal of the American Society of Echocardiography
Volume21
Issue number2
DOIs
StatePublished - Feb 1 2008

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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