Atrium electromechanical interval in left ventricular diastolic dysfunction

Authors

  • Tze-Fan Chao,

    1. Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan and Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan
    Search for more papers by this author
  • Kang-Ling Wang,

    1. Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan and Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan
    Search for more papers by this author
  • Chi-Fang Chuang,

    1. Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan and Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan
    Search for more papers by this author
  • Shih-Ann Chen,

    1. Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan and Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan
    Search for more papers by this author
  • Wen-Chung Yu

    1. Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan and Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan
    Search for more papers by this author

  • Dr. Tze-Fan Chao and Dr. Kang-Ling Wang contributed equally to this study.

Wen-Chung Yu, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, 201 Sec. 2, Shih-Pai Road, Taipei, Taiwan. Tel.: 886 2 2871 2121 ext 2997; fax: 886 2 2877 1746; e-mail: wcyu@vghtpe.gov.tw

Abstract

Eur J Clin Invest 2011

Abstract

Background  Left ventricular (LV) diastolic dysfunction has great effects on the left atrium (LA). A recently developed electromechanical interval (PA-TDI), which was determined as the time interval from the initiation of P wave deflection to the peak of local lateral LA tissue Doppler imaging signal, was reported to be associated with LA electrophysiological properties. The goal of our study was to evaluate the association between the PA-TDI interval and LV diastolic function.

Materials and methods  A total of 224 consecutive patients were enrolled. LV diastolic dysfunction was defined as either (i) impaired relaxation: E/A ratio < 0·75 and E/E′ ratio < 10, (ii) pseudonormal pattern: 0·75 ≤ E/A ratio < 1·5 and E/E′ ratio > 10 or (iii) restrictive pattern: E/A ratio ≥ 1·5 and E/E′ ratio > 10. The PA-TDI intervals were measured and compared between patients with and without diastolic dysfunction.

Results  Fifty-six per cent of the study population had abnormal diastolic function. The PA-TDI interval was significantly longer in the diastolic dysfunction group than that in the normal group (147·8 ± 18·2 vs. 130·4 ± 17·0 ms, P < 0·01). In patients with diastolic dysfunction, the PA-TDI intervals became progressively longer as the diastolic dysfunction progressed from impaired relaxation (141·2 ± 11·4 ms), pseudonormal pattern (147·6 ± 18·0 ms) to restrictive pattern (164·1 ± 20·9 ms).

Conclusions  The PA-TDI interval was significantly longer in patients with LV diastolic dysfunction than those without it. Its prolongation may reflect the severity of atrial remodelling because of the abnormal diastolic function of LV.

Ancillary