ANALYSIS OF LEFT ATRIOVENTRICULAR PLANE MOVEMENT DURING DIASTOLE IN ISCHEMIC-HEART-DISEASE

The aim of the present study was to investigate the properties of dias tolic left atrioventricular plane displacement (AVPD) in coronary arte ry disease (CAD) patients. In 125 patients (mean age 58.7 +/- 13.7) wi th CAD and in 51 age-matched healthy subjects, a complete transthoraci c echocardiographic study was performed. The AVPD was recorded by M-mo de echocardiography, from apical four and two chamber views at four si tes corresponding- to the septal, lateral, anterior and inferior walls of the left ventricle. Mean AVPD in early diastole (E-AVPD), mean AVP D from atrial systole (A-AVPD) and the ratio A-AVPD/E-AVPD were determ ined. In normal subjects, such as in 35 patients without left ventricu lar segmental wall motion abnormalities (SWMA), stepwise multiple regr ession analysis showed none of these factors to be significantly relat ed to E-AVPD or A-AVPD. Aging was correlated negatively to the E-AVPD/ A-AVPD ratio (p < 0.05). In 90 patients with left ventricular SWMA, st epwise multiple regression analysis showed that indices of left ventri cular systolic function correlated positively to E-AVPD (p < 0.001) an d A-AVPD (P < 0.001). The E-AVPD/A-AVPD ratio was correlated to left v entricular ejection fraction and heart rate(p < 0.005). Mean E-AVPD wa s significantly lower in CAD patients than in normal subjects (P < 0.0 01), while A-AVPD was higher in patients without left ventricular SWMA in comparison to normal subjects (p = 0.02). Also, mean A-AVPD/E-AVPD was higher in CAD patients than in the control group (P < 0.001). Mea n E-AVPD/A-AVPD was correlated to the E/A ratio of transmitral flow in CAD patients with (r = 0.669) and without (r = 0.771) SWMA. The E-AVP D and A-AVPD in CAD patients with SWMA is reduced according to the det erioration of left ventricular systolic function. The atrial contribut ion to the longitudinal distension of the left ventricle is increased in CAD patients. In CAD patients, especially those without left ventri cular SWMA, the E-AVPD/A-AVPD ratio has a good correlation to left ven tricular filling behavior.