Abstract 703: Usefulness of Dual Doppler System in Estimating Left Ventricular Filling Pressure in Patients with Atrial Fibrillation -Temporal Analysis of Simultaneous Measurement of Transmitral Inflow and Mitral Annular Velocity-

Abstract

Background: A ratio of early transmitral flow velocity (E) to early diastolic mitral annular velocity (E′) and a time interval between onsets of E and E′ (T E′-E ) has been proposed as a novel index to assess left ventricular (LV) filling pressure (FP). However, in patients with atrial fibrillation (AF), it is often difficult to obtain steady Doppler-derived values because of fluctuating R-R intervals. Recently, simultaneous recording of E and E′, and calculation of E/E′ and T E′-E n each cardiac cycle has been feasible with dual Doppler system (Hitachi EUB7500). Methods: Forty patients with AF were analyzed to evaluate the feasibility for estimating LVFP by simultaneous recording of E and E′. We measured E/E′ and T E′-E corrected by R-R interval (cT E′-E ) using a dual Doppler system, and LV pre-atrial pressure (pre-A) in 5 consecutive cardiac cycles. Results: E/E′ and cT E′-E had significant correlations with pre-A (E/E′: r=0.58, p<0.001; cT E′-E : r=0.78, p<0.001). The receiver-operating characteristic (ROC) analysis revealed that cut-off value of cT E′-E >34ms 0.5 had higher specificity and sensitivity to predicted pre-A>12mmHg than the value of E/E′ >10.1 (cT E′-E : sensitivity 94%, specificity 87%, E/E′: sensitivity 67%, specificity 43%). Conclusions: Even in patients with AF, the temporal analysis of E and E′ by the dual Doppler system was available for estimating elevated LVFP and provided an incremental value in addition to velocity analysis of pulsed and tissue Doppler indices.