SIGNIFICANCE OF ECHOCARDIOGRAPHIC ATRIOVENTRICULAR PLANE DISPLACEMENTFOR THE EVALUATION OF LEFT-VENTRICULAR FILLING AND END-DIASTOLIC PRESSURE IN PATIENTS WITH CORONARY-ARTERY DISEASE

The aim of this study is to assess the left ventricular filling and es timate the end-diastolic pressure of the left ventricle in patients wi th coronary artery disease (CAD) by echocardiographic measurement of t he atrioventricular plane displacement (AVPD). In 101 patients (mean a ge 59 +/- 12 years) with CAD, a complete transthoracic echocardiograph ic study was performed, just prior to cardiac catheterization. The AVP D was recorded by M-mode echocardiography, from apical four and two ch amber views. The recordings were obtained at four sites, corresponding to the septal, lateral, anterior and inferior walls of the left ventr icle. The mean AVPD resulting from atrial systole (At), the mean total (T) diastolic AVPD, the ratio At/T(%) and the ratio of mitral annulus excursion during early and late diastole [(T-At)/At] were calculated. Firty-two age-matched healthy subjects served as control group. Both At and At/T were significantly greater in patients with CAD than in th e controls (6.06 +/- 0.94 vs 5.53 +/- 0.55 mm, p < 0.01 and 43.4 +/- 5 .9% vs 33.49 +/- 4.45%, p < 0.001 respectively). The ratio [(T-At)/At] correlated with the E/A ratio of transmitral flow, both in healthy su bjects (r = 0.850, p < 0.001) and in patients with CAD (r = 0.722, p < 0.001). Correlation also existed both in patients with segmental wall motion abnormality (SWMA) (r = 0.691, p < 0.001) and in patients with SWMA (r = 0.818, p < 0.001). In patients with CAD, At/T further corre lated with the left ventricular end-diastolic pressure (r = 0.517, p < 0.001). In patients with SWMA and in patients without, a correlation was also found (r = 0.516, p < 0.001 and r = 0.566, p < 0.001 respecti vely). In conclusion, AVPD measured by echocardiography can be used as a simple noninvasive parameter to evaluate left ventricular filling i n patients with CAD and for the gross estimation of end-diastolic pres sure of left ventricle.