Volume 25, Issue 3 pp. 249-255

Preload Dependence of the Time Interval between Onsets of Mitral Inflow and Early Diastolic Mitral Annular Velocity: A Study in Healthy Subjects

Jean-Claude Mukonkole Lubanda M.D.

Jean-Claude Mukonkole Lubanda M.D.

2nd Medical Department—Clinical Department of Cardiology and Angiology, General University Hospital, Charles University in Prague, First Faculty of Medicine, Czech Republic

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Tomas Palecek M.D.

Tomas Palecek M.D.

2nd Medical Department—Clinical Department of Cardiology and Angiology, General University Hospital, Charles University in Prague, First Faculty of Medicine, Czech Republic

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Radka Trckova R.N.

Radka Trckova R.N.

2nd Medical Department—Clinical Department of Cardiology and Angiology, General University Hospital, Charles University in Prague, First Faculty of Medicine, Czech Republic

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James Michael Wilson M.D.

James Michael Wilson M.D.

Texas Heart Institute at St. Luke's Episcopal Hospital, Houston, Texas, USA

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Ales Linhart M.D., Ph.D.

Ales Linhart M.D., Ph.D.

2nd Medical Department—Clinical Department of Cardiology and Angiology, General University Hospital, Charles University in Prague, First Faculty of Medicine, Czech Republic

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First published: 12 November 2007
Citations: 4
Address for correspondence and reprint requests: Tomas Palecek, M.D., 2nd Medical Department—Clinical Department of Cardiology and Angiology, General University Hospital, U Nemocnice 2, 128 08 Prague 2, Czech Republic. Fax: +4202 24912154; E-mail: [email protected]

Financial support by the Cardiovascular research project of the Charles University, Prague, Czech Republic, nr. 0021620817.

Abstract

The time interval (TEa–E) between onsets of early diastolic mitral annular velocity (Ea) and early mitral inflow velocity (E) has been proposed as a new index of left ventricular (LV) relaxation. We aimed to assess the influence of preload changes on this parameter by examining 25 healthy volunteers at rest, after passive leg lifting, and after administration of nitroglycerin combined with Valsalva maneuver. To obtain septal and lateral TEa–E, the time intervals between peak R-wave on electrocardiogram and the onsets of Ea and E were measured in different cardiac cycles. E and Ea were significantly changed by preload manipulations. We did not observe significant changes of TEa–E intervals after leg lifting or after nitroglycerin administration combined with Valsalva maneuver (P = NS). TEa–E was < 0 ms in several subjects using either septal or lateral Ea recordings. We conclude that TEa–E may be load independent in subjects with normal LV systolic and diastolic function as compared to other Doppler parameters. Therefore, this index could be potentially used as a reliable noninvasive parameter of LV relaxation. Nevertheless, even slight differences in cardiac cycle lengths might influence the measurements of TEa–E interval. For that reason, the clinical use of TEa–E seems to be significantly limited because of a wide margin of error in its measurement due to the inability to obtain Doppler recordings during the same cardiac cycle.

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