JOURNAL OF CLINICAL AND BIOMEDICAL SCIENCES

Abstract

Background: Diastolic dysfunction in patients with congestive cardiac failure contributes to a significant mortality and morbidity. The present study has been envisaged to determine the accuracy of TDI findings with Doppler echocardiography in determining the left ventricular filling pressure. Materials and Methods: Tissue Doppler imaging was performed for Ea, Em, E/Ea, deceleration time (DT) measurements. These variables were analyzed individually, as the average of the medial and lateral annulus, and as the maximum of the medial and lateral annulus. Tests of diagnostic accuracy were applied for significant variables.. Results: A total of 100 consecutive patients were enrolled of which 82 had angina and 18 had congestive cardiac failure. Comparison of various Doppler parameters in the study participants revealed a significant correlation between DT and LVEDP (r = 0.52) in patients with EF < 50 but not in those with EF > 50% (r =0.18). E/Em medi-al annulus had a sensitivity of 90.9 % [95% CI -78, 97] and specificity of 89.28% [95% CI-78, 95) with a PPV of 86.95 % [95% CI-73, 95] and NPV = 92.59 % [95% CI-82, 97] of predicting LVEDP as compared to individuals with a raised LVEDP. The areas under the curves were 0.82 and 0.75 for the medial and lateral annulus, respectively. Conclusions: The present study shows that the E/Em ratio shall perform as a good initial measure while estimating of left ventricular filling pressures, particularly in those patients with preserved systolic function.

Keywords: Diastolic dysfunction, Doppler echocardiography , E/Em ratio, systolic function.