USE OF INTRAVENTRICULAR DISPERSION OF THE PEAK DIASTOLIC FLOW VELOCITY AS A MARKER OF LEFT-VENTRICULAR DIASTOLIC DYSFUNCTION IN PATIENTS WITH ATRIAL-FIBRILLATION

The aim of this study was to evaluate the use of intraventricular disp ersion of the peak diastolic Row velocity as a marker of left ventricu lar diastolic dysfunction in patients with atrial fibrillation. Region al diastolic Row velocity patterns at 1, 2, and 3 cm away from the mit ral tip toward the apex were simultaneously recorded with the mitral f low velocity pattern by using pulsed Doppler echocardiography in 24 pa tients with atrial fibrillation before electrical or medical cardiover sion. Echocardiographic examination was repeated after 10 to 30 days ( ie, at the time of recovery of left atrial mechanical functions) after cardioversion of atrial fibrillation in all patients. Thirteen patien ts were found to have diastolic dysfunction; the remaining 11 patients with a normal E/A ratio constituted the control group. Afterward, the data recorded before the cardioversion were analyzed for each patient . in subjects with normal diastolic function, the peak diastolic flow velocity ((PDFV) at the mitral tips also was maintained at the positio ns 1 to 3 cm away from the tip In the left ventricular cavity (PDFV at the mitral tips: 0.84 m/s, PDFV at 3 cm: 0.85 m/s; P = .34). In contr ast, the regional PDFV progressively decreased toward the apex- in pat ients with diastolic dysfunction (PDFV at the mitral tips: 0.82 m/s, P DFV at 3 cm: 0.63 m/s: p = .0004). Only 77% of the initial velocity wa s maintained at 3 cm away from the mitral tips in patients with diasto lic dysfunction, whereas almost 100% of the: Initial velocity was pres erved In patients with normal diastolic function (P < .001). These fin dings suggest that the assessment of the intraventricular decrease in mitral PDFV may be used as a reliable marker of diastolic dysfunction in patients with atrial fibrillation.