To define the role of left atrial (LA) volume change rate, as indicated by posterior aortic wall motion during the left ventricular (LV) diastolic phase, in the assessment of LV diastolic function.
One hundred and fifty-five patients who underwent echocardiography after cardiac catheterization were included in this study. These patients were classified into four groups according to the ratio of early to late transmitral flow velocity (E/A ratio) and/or LV end-diastolic pressure (EDP): 42 patients with LVEDP <15 mm Hg and E/A ratio >1(normal filling); 46 patients with E/A <1 (impaired relaxation); 46 patients with LVEDP ≥15 mm Hg and E/A>1 and <2 (pseudonormal filling); 21 patients with E/A >2, E ≥70 cm/sec, and E wave deceleration time ≤160 msec (restrictive filling). The slopes of early and late (slope E and A) diastolic motion of the LA wall were derived from M-mode analysis, together with the LV isovolumic time constant Tau from cardiac catheterization.
Values of the slope E/A were decreased in patients with restrictive filling, pseudonormal filling, and impaired relaxation compared to those with normal filling (0.43 ± 0.15, 0.69 ± 0.15, and 0.56 ± 0.23 vs. 1.25 ± 0.26, p <0.001, respectively) and were correlated inversely with the isovolumic time constant Tau (r = 0.79, p <0.001).
Analysis of the slope of LA wall motion as an indicator of LA volume change rate during the LV diastolic phase is useful in evaluating LV diastolic function.
The analysis is free of the effects of pseudonormalization and is well correlated with the isovolumic time constant Tau.
M. Hung, None.