ASSESSMENT OF MITRAL ANNULAR DYNAMICS DURING DIASTOLE BY DOPPLER TISSUE IMAGING - COMPARISON WITH MITRAL DOPPLER INFLOW IN SUBJECTS WITHOUTHEART-DISEASE AND IN PATIENTS WITH LEFT-VENTRICULAR HYPERTROPHY

The purpose of this study was to determine the normal pattern and magn itude of mitral annular velocities in diastole by Doppler tissue imagi ng (DII) and to assess whether this is altered in patients with left v entricular hypertrophy. Mitral annulus velocities were measured by DTI . Peak and time-velocity integral were measured from the DTI tracings and the timing of the velocities in relation to electrocardiogram. DTI was compared with M-mode echo of the annulus and mitral inflow Dopple r velocities. Integrated annular velocities by DTI correlated with the annular displacement. Early diastolic velocities decreased with age a nd in patients with left ventricular hypertrophy. In the hypertrophy g roup, early diastolic velocities were significantly lower than normal even after correcting for age. Patients with left ventricular hypertro phy also showed a delay in peak early diastolic mitral annular velocit y (5.5 +/- 21 msec after the E wave). In conclusion, mitral annular ve locity in diastole is readily recorded by DTI. The magnitude and the p attern of these velocities are significantly altered by age and by lef t ventricular hypertrophy. This method provides a new insight into dia stolic filling events and may prove useful in detecting abnormal diast olic function.