Division of Cardiology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, # 896, Pyeongchon-dong, Dongan-gu, Anyang-Si, Gyeonggi-do 431-070, Korea.
Eur Heart J Cardiovasc Imaging. 2013 May;14(5):443-8. doi: 10.1093/ehjci/jes176. Epub 2012 Aug 21.
The reversal of the early diastolic mitral annular velocity (e') to the late diastolic mitral annular velocity (a') ratio (e'/a' <1) develops earlier in the septum than in the lateral mitral annulus on tissue Doppler imaging (TDI). Accordingly, patients with isolated diastolic dysfunction presenting as a reversed septal e'/a' ratio can be divided into two groups depending on the presence of a reversal of lateral e'/a'. The aim of this study was to identify the determinants of preserved diastolic function at the lateral annulus in patients with isolated diastolic dysfunction.
A total of 1166 consecutive patients with isolated diastolic dysfunction presenting as a reversed septal e'/a' were classified on the basis of their diastolic function at the lateral mitral annulus. Two hundred and fifteen patients had a preserved lateral e'/a' (e'/a' >1) and 915 patients had a reversed lateral e'/a' (e'/a' <1). Patients with lateral e'/a' >1 were younger, male, and had a lower prevalence of diabetes and hypertension and showed less evidence of left ventricular (LV) diastolic dysfunction and structural remodelling as LV hypertrophy and LA enlargement, than those with a lateral e'/a' <1. Multivariate analysis revealed that age, septal e', septal peak systolic annular velocity, and LV mass indexed to height(2.7) (LVM/h(2.7)) were independently associated with preserved diastolic function at the lateral annulus.
The age, septal TDI, and LVM/h(2.7) were independent determinants of preserved diastolic function at the lateral annulus in patients with isolated diastolic dysfunction presenting as a reversed septal e'/a' ratio.
组织多普勒成像（TDI）显示，早期舒张期二尖瓣环速度（e'）向晚期舒张期二尖瓣环速度（a'）的逆转（e'/a' <1）在间隔部比在外侧壁出现得更早。因此，孤立性舒张功能障碍患者中，出现反向间隔部 e'/a'比值的患者可以根据外侧 e'/a'的逆转情况分为两组。本研究旨在确定孤立性舒张功能障碍患者中外侧瓣环舒张功能保留的决定因素。
共有 1166 例连续孤立性舒张功能障碍患者表现为反向间隔部 e'/a'，根据其外侧二尖瓣环的舒张功能进行分类。215 例患者外侧 e'/a'保留（e'/a' >1），915 例患者外侧 e'/a'逆转（e'/a' <1）。外侧 e'/a' >1 的患者较外侧 e'/a' <1 的患者更年轻、男性，糖尿病和高血压的患病率更低，左心室（LV）舒张功能和结构重构的证据（如 LV 肥厚和 LA 增大）也较少。多变量分析显示，年龄、间隔部 e'、间隔部收缩期峰值环速度和 LV 质量指数化到身高的平方（LVM/h(2.7)）与外侧瓣环的舒张功能保留独立相关。
在孤立性舒张功能障碍患者中，出现反向间隔部 e'/a'比值时，年龄、间隔部 TDI 和 LVM/h(2.7)是外侧瓣环舒张功能保留的独立决定因素。
