Mitral annulus velocity in the evaluation of left ventricular diastolic function in atrial fibrillation

This study assessed the clinical utility of mitral annulus velocity in the evaluation of left ventricular diastolic function Ln patients with atrial f ibrillation. Atrial fibrillation is the most common sustained arrhythmia en countered in, clinical practice. The clinical usefulness of conventional Do ppler indexes is limited in atrial fibrillation because of the altered left atrial pressure and loss of synchronized atrial contraction. Mitral inflow and mitral annulus velocities mere measured simultaneously with tau in 27 patients with nonrheumatic atrial fibrillation at the cardiac catheterizati on laboratory. Among deceleration time of mitral inflow, peak mitral inflow velocity (E), and peak diastolic mitral annulus velocity (E'), only E' cor related with tau (r = 0.51, P = .007). Prolonged tau (greater than or equal to 50 ms) could be predicted by E' <8 cm/s with a sensitivity of 73% (16 o f 22) and a specificity of 100% (5 of 5) The E/E' ratio correlated with lef t ventricular filling pressure (r = 0.79, P <.001). The E/E' ratio of great er than or equal to 11 could predict elevated left ventricular filling pres sure (greater than or equal to 15 mm Hg) with a sensitivity of 75% (9 of 12 ) and a specificity of 93% (14 of 15). Mitral annulus velocity is useful in the detection of impaired left ventricular relaxation and estimation of fi lling pressure even in patients with atrial fibrillation.