EFFECT OF APICAL SEGMENTAL DYSFUNCTION ON EARLY DIASTOLIC ANNULAR TISSUE VELOCITY

Abstract

Background: Apical segments contribute to early LV filling by actively drawing blood from mid and basal levels into the apical region, by means of relaxation and elastic recoil (suction) effect. Longitudinal axis early diastolic annular tissue velocity (Ea) is influenced by relaxation and suction of LV. Objective: To analyze the influence of apical segmental dysfunction on peak Ea velocity in a clinical model, as chronic Chagas disease cardiomyopathy (ChD) in which apical aneurysm is a common finding. Methods: Forty‐four patients with ChD (49 ± 8 years), ejection fraction (EF) > 45% and 20 age‐matched normal subjects (N) were studied. Twenty‐one patients with ChD had normal wall motion (G 1) and 23 patients had apical aneurysm (G 2). EF, peak Ea velocity of the lateral mitral annulus (tissue Doppler imaging), peak E and A velocities and E/A ratio (transmitral pulsed Doppler) were measured. Analysis of variance was used to compare groups. Results: Mean value ± standard deviation, p < 0.001 vs N, *p < 0.01 vs G 1; EF was not significantly different in the three groups. Ea (m/s) E/A N 0.17 ± 0.07 1.38 ± 0.32 G1 0.15 ± 0.04 1.34 ± 0.47 G2 0.11 ± 0.03 1.21 ± 0.54 Conclusion: Patients with ChD and apical aneurysm (G 2) had peak Ea velocity significantly decreased in comparison with patients without aneurysm (G 1), although they had no difference in EF and pulsed Doppler index. In a clinical model as ChD, these findings suggest that apical segmental dysfunction influenced early diastolic annular tissue velocity.