MITRAL ANNULAR DESCENT VELOCITY BY TISSUE DOPPLER-ECHOCARDIOGRAPHY ASAN INDEX GLOBAL LEFT-VENTRICULAR FUNCTION

Mitral annular descent has been described as an index of left ventricu lar (LV) systolic function, which is independent of endocardial defini tion. Echocardiographic tissue Doppler imaging is a new technique that calculates and displays color-coded cardiac tissue velocities on-line . To evaluate mitral annular descent velocity as a rapid index of glob al LV function, we performed tissue Doppler imaging studies in 55 pati ents, aged 56 +/- 15 years, within 3 hours of radionuclide ventriculog raphic ejection fraction. Tissue Doppler M-mode studies were obtained from each of 6 mitral annular sites, as follows: inferoseptal and late ral from apical 4-chamber views, anterior and inferior from apical 2-c hamber views, and anteroseptal and posterior from apical long-axis vie ws, Only 1 patient with severe mitral annular calcification wets exclu ded. The group mean 6-site average peak mitral annular descent velocit y was 5.5 +/- 1.9 cm/s (range 2.4 to 10.5), and the group mean ejectio n fraction was 49 +/- 18% (range 17 to 80%), The 6-site average peak a nnular descent velocity correlated linearly with LV ejection fraction (r = 0.86, SEE = 1.02 cm/s): LV ejection fraction = 8.2 (average peak mitral annular descent velocity) + 3%. The 6-site peak mitral annular descent velocity average > 5.4 cm/s was 88% sensitive and 97% specific for ejection fraction > 50%, The peak mitral annular descent velocity from the apical 4-chamber view (average from inferoseptal and lateral sites) correlated most closely with the LV ejection fraction (r = 0.8 5) as an individual view, Peak mitral annular descent velocity by tiss ue Doppler imaging has the potential to estimate rapidly the global LV function.