Prognostic Significance of Left Ventricular Diastolic Dysfunction Assessed by Color M-mode Doppler Echocardiography in Patients With Chronic Left Ventricular Systolic Dysfunction

Abstract

Background. Color M-mode Doppler echocardiography provides accurate evaluation of LV diastolic function noninvasively and is reportedly preload independent compared with pulsed Doppler transmitral velocity indexes. This study aimed to determine the prognostic significance of left ventricular (LV) diastolic function in patients with different degrees of chronic LV systolic dysfunction using color M-mode Doppler echocardiography. Methods.A total of 98 consecutive subjects (mean age 57 years, 78 males) with LV systolic dysfunction (61 with previous myocardial infarction and 37 with dilated cardiomyopathy) underwent clinical and echocardiographic evaluation to determine functional status. Measurements of LV and left atrial dimensions, LV ejection fraction (EF), the peak of early and late diastolic transmitral velocities (E and A, respectively), the E/A ratio, deceleration time of E velocity and isovolumic relaxation time using conventional echo-Doppler techniques, and LV flow propagation velocity (FPV) and FPV/E using color M-mode Doppler echocardiography were taken.Results. During the mean follow-up period of 37±28 months, 26 patients had cardiovascular events (death in 4, congestive heart failure in 13, ventricular tachycardia in 6, and cerebral infarction in 3). EF was the single independent predictor of cardiovascular events. While, in the subgroup with EF <0.35, the functional class was the single significant predictor of cardiovascular events, FPV/E was the single best predictor of cardiovascular events in the subgroup with EF ≥0.35.Conclusions. The evaluation of LV diastolic function using color M-mode Doppler-derived FPV/E contributes to predicting clinical outcomes of patients with mildly depressed LV systolic function. (J Echocardiogr 2004; 2: 68-77)

Left Ventricular Outflow Tract Obstruction Provoked by Catecholamine in Acute Myocardial Infarction: Mechanistic Insights From An Animal Experiment

“…Therefore, the results are consistent with the hypothesis of this study. Relation to previous studies Systolic and diastolic LV dysfunction is the basic cause of congestive heart failure [15][16][17]. However, associated mitral valve dysfunction is also critically important in patients with congestive heart failure [18][19][20].…”