Doppler Echocardiography for the Estimation of LV Filling Pressure in Patients With Mitral Annular Calcification

Abstract

The E/e' ratio should not be used to estimate LVFP in subjects with significant MAC. However, mitral E/A ratio and IVRT are useful predictors of LVFP in this patient population. The proposed decision algorithm combining these Doppler parameters is accurate in estimating LVFP in patients with MAC.

Normal reference values of diastolic strain rate in healthy individuals: Chronological trends and the comparison according to genders

“…In technical aspects, DSR is based on multi‐directional tracking and is free from an alignment angle which is a major drawback of the Doppler technique . Other pitfalls of TDI from regional akinesia, tethering, and annular calcification can be overcome by DSR . But all these are theoretical advantages at this moment; thus, the efficacy of DSR should be proven through various clinical studies.…”

Effect of transcatheter aortic valve replacement on left atrial function

“…Both reduced LA reservoir conduit function as well as absent or reduced pump function are commonly observed in patients with AF from published studies . Importantly, LV diastolic function improved in the majority of the patients over time as assessed by recently proposed criteria using E/A ratio and IVRT duration as well decreased RVSP. From a pathophysiological point of view, our findings could be explained by the significant afterload reduction benefit which followed TAVR.…”

“…Diastolic function was assessed using recently proposed criteria by Abudiab et al as the majority of patients had moderate and severe mitral annular calcification . High left ventricular filling pressure was defined as a mitral E/A ratio more than 1.8 or ratio of 0.8 to 1.8 and isovolumic relaxation time (IVRT) less than 80 ms . Echocardiographic indices were measured following the American Society of echocardiography standards …”

Evolution of diastolic function algorithms: Implications for clinical practice

“…The situation is made more complicated when significant mitral regurgitation is present, which also is associated with an elevated transmitral velocity . At present, we must use alternative approaches to assess diastolic function in the presence of MAC; methods utilizing the E:A and IVRT have been demonstrated to be useful in the identification of elevated filling pressures . The indexation of the E velocity by diastolic strain rate may have clinical utility as well .…”

“…[19][20][21][22] At present, we must use alternative approaches to assess diastolic function in the presence of MAC; methods utilizing the E:A and IVRT have been demonstrated to be useful in the identification of elevated filling pressures. 23 The indexation of the E velocity by diastolic strain rate may have clinical utility as well. [24][25][26][27][28] This diagnostic difficulty is likely to become more common as the prevalence of MAC increases along with the mean age of the population undergoing echocardiography.…”