Evaluation of left ventricular diastolic function when mitral E and A waves are completely fused: Role of assessing mitral annulus velocity

Mitral inflow parameters have been used most widely in the evaluation of le ft ventricular (LV) diastolic function. However, when the mitral E and A wa ves are completely fused, mitral inflow parameters cannot provide informati on about the LV diastolic function. LV filling pressure, mitral inflow, mit ral annulus velocity, and tau (tau) were measured in 59 patients with sinus rhythm when mitral E and A waves were completely fused with right atrial p acing. When mitral E and A waves were completely fused, tau correlated with the peak fused mitral annulus velocity (r = -0.60, P < .001), and peak fus ed mitral annulus velocity of less than 12.5 cm/s best discriminated prolon ged (greater than or equal to 50 ms) from normal tau, with a sensitivity of 78% and specificity of 69%. The peak fused mitral inflow velocity to peak fused mitral annulus velocity ratio correlated with LV filling pressure (r = 0.62, P < .001). A ratio of at least 8, could predict elevated LV filling pressure (greater than or equal to 15 mm Hg) with a sensitivity of 65% and specificity of 74%. In conclusion, even when mitral E and A waves are comp letely fused, mitral annulus velocity can be used in the evaluation of LV d iastolic function.