Mitral annulus velocities and time intervals for evaluation of global left ventricular diastolic function in patients with coronary artery disease

AIM: To detect and compare the longitudinal mitral annulus diastolic velocity and time interval changes by pulsed Doppler tissue imaging (DTI) in patients with angina pectoris (AP) and myocardial infarction (MI), and to explore the value of mitral annulus diastolic velocities and time intervals for evaluation of global left ventricular diastolic dysfunction. METHODS: Fifty patients with established coronary artery disease were divided into AP group (16 cases) and MI group (34 cases). Sixteen age-matched healthy individuals served as the control group. The septum, lateral, anterior and inferior walls of the mitral annulus were displayed, and selected for DTI spectrum sampling. Peak early and late diastolic velocities and their ratio, time to the onset and peak of the early diastolic wave, and regional isovolumic relaxation time were measured, and the average values of the four mitral annular sites were calculated and presented as Em, Am, Em/Am, QEm, TEm and IVRTm, respectively. RESULTS: Compared with the control group, Em and Em/Am were significantly lower in both the AP and the MI groups (P<0.01). Em was even lower in the MI group than that in the AP group (P<0.01). QEm, TEm and IVRTm were significantly longer in the AP and the MI groups than those in control group (P<0.01 or P<0.05). IVRTm was even longer in the MI group than that in AP group (P<0.01). IVRTm had significantly negative correlation with Em (r=-0.64, P<0.01). CONCLUSION: Em, Em/Am, QEm, TEm and IVRTm as measured by pulsed DTI may be promising indexes for quantitative assessment of global left ventricular diastolic dysfunction in patients with coronary artery disease. Em and IVRTm may indicate the severity of ischemic myocardial damage.