Correlation of the M-mode atrioventricular plane early diastolic downward slope and systolic parameters. Coupling of LV systolic and early diastolic function.

Abstract

The early diastolic downward slope (EDS) of the left atrioventricular plane displacement (AVPD) is a parameter of early left ventricular (LV) diastolic filling, particularly useful in revealing pseudonormalisation of the transmitral Doppler early to atrial (E/A) ratio. In recent studies LV early diastolic function seems to be closely linked to LV systolic function. In order to further examine this relationship we studied the correlation between EDS and traditional Doppler parameters of LV diastolic function as well as between EDS and systolic parameters. LV diastolic function was assessed by echocardiography/Doppler in 62 consecutive patients by measurement of EDS and using a traditional four-grade scale based on a combination of the E/A ratio, the E-wave deceleration time (Edt), and the systolic/diastolic ratio of the pulmonary venous inflow (S/D). LV systolic function was evaluated by ejection fraction (LVEF) and AVPD. EDS was assessed from AVPD registrations. In univariate analysis of variance (ANOVA), EDS was not significantly related to overall diastolic function, but highly significantly related to both LVEF (p = 0.001) and AVPD (p < 0.0001). EDS was more closely related to LV systolic parameters than to LV diastolic function assessed traditionally by Doppler, using a combination of E/A, Edt and S/D. This relationship between the early filling of the LV and the LV systolic function is in line with some earlier findings. It is suggestive of a relationship between the systolic and early diastolic performance of the LV.