Findings of automatic border detection in subjects with left ventricular diastolic dysfunction by Doppler echocardiography

Abstract

Left ventricular automatic border detection (ABD) patterns were defined in the parasternal short-axis and the apical four-chamber views and were compared with pulsed-wave diastolic Doppler flow-velocity patterns of the mitral valve in 49 subjects (aged 39 to 87 years), 10 selected normal individuals, and 39 consecutive patients with high-quality echocardiographic Doppler studies and relaxation abnormalities (Doppler peak early diastolic velocity/peak late velocity ratio < 1). Both short-axis and apical four-chamber views were useful in the assessment of diastolic function by ABD. However, in subjects with high-quality two-dimensional echocardiographic Doppler studies, ABD was technically more feasible in the apical four-chamber view (97%; 38/39 subjects) than in the short-axis view (64%; 25/39 subjects) and correlated better with Doppler parameters. Compared with normal subjects, patients with abnormal Doppler relaxation patterns showed significant differences in diastolic filling indexes obtained by the ABD technique. The ratio of peak rapid filling rate/peak atrial filling rate (PRFR/PAFR) obtained from the dA/dt waveform in the apical four-chamber view had the highest correlation with Doppler indexes (r = 0.79). A PRFR/PAFR ratio of 1.5 best discriminated between normal individuals and subjects with relaxation abnormalities, with high sensitivity and specificity (95% and 100%, respectively). The PRFR/PAFR ratio obtained from the dA/dt waveform seemed to be a simple and useful method to distinguish between normal and abnormal left ventricular diastolic filling, as defined by Doppler echocardiography.