Simultaneous Doppler Tracing of Transmitral Inflow and Mitral Annular Velocity as an Estimate of Elevated Left Ventricular Filling Pressure in Patients With Atrial Fibrillation

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著者

    • WADA Yasuaki
    • Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine
    • TANAKA Takeo
    • Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine
    • NOSE Yoshio
    • Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine
    • KIHARA Chikage
    • Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine
    • UCHIDA Kosuke
    • Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine
    • OKUDA Shinichi
    • Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine
    • SUSA Takehisa
    • Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine

抄録

<b><i>Background:</i></b> The time interval between the onset of early transmitral flow velocity (E) and that of early diastolic mitral annular velocity (e') (T<sub>E-e'</sub>) is a good predictor of elevated left ventricular (LV) filling pressure in patients with sinus rhythm. Although the evaluation of LV filling pressure using E/e' has been challenging in atrial fibrillation (AF), the usefulness of T<sub>E-e'</sub> is unknown. <b><i>Methods and Results:</i></b> E and e' were simultaneously recorded using dual Doppler echocardiography in 45 AF patients (30 men; mean age, 69±9 years). E/e' and T<sub>E-e'</sub> were calculated and compared with the pulmonary capillary wedge pressure (PCWP), which was measured invasively. E/e' and T<sub>E/e'</sub> correlated with PCWP (E/e', r=0.57, P<0.001; T<sub>E-e'</sub>, r=0.77, P<0.001). Using receiver operating characteristic analysis, the optimal cut-off for T<sub>E-e'</sub> was 34ms (sensitivity, 95%; specificity, 88%) and that for E/e' was 14.6 (sensitivity, 50%; specificity, 84%) in order to predict >12-mmHg PCWP. When the combined cut-offs of T<sub>E-e'</sub> >34ms and E/e' >14.6 were used, the sensitivity and specificity of predicting elevated PCWP were improved to 100% and 88%, respectively. <b><i>Conclusions:</i></b> In AF patients, the simultaneous recording of E and e' using dual Doppler echocardiography and the analysis of T<sub>E-e'</sub>, in addition to E/e', improved the accuracy of evaluation of LV filling pressure. (<i>Circ J</i> 2012; <b>76:</b> 675-681)<br>

収録刊行物

  • Circulation journal : official journal of the Japanese Circulation Society

    Circulation journal : official journal of the Japanese Circulation Society 76(3), 675-681, 2012-02-25

    一般社団法人 日本循環器学会

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各種コード

  • NII論文ID(NAID)
    10030130157
  • NII書誌ID(NCID)
    AA11591968
  • 本文言語コード
    ENG
  • 資料種別
    ART
  • ISSN
    13469843
  • データ提供元
    CJP書誌  J-STAGE 
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