• I Iglesias Garriz, M A Rodríguez García, S Delgado Fernández, C Garrote Coloma, M Sastre Ibarretxe, and F Corral Fernández.
• Laboratorio de Cardiología no Invasiva. Servicio de Cardiología. Hospital de León. León. med016340@nacom.es
• Rev Esp Cardiol. 2000 Sep 1; 53 (9): 1195-200.

Introduction And ObjectivesWe assessed the Doppler tissue imaging technique in the left mitral annulus of patients with left ventricular systolic dysfunction since the technique has been used to evaluate diastolic function of the left ventricle and the values obtained have been considered to be relatively independent of the preload.Patients And MethodsPatients (n = 46) with an ejection fraction < 40% in sinus rhythm without mitral regurgitation underwent pulsed wave Doppler analyses of mitral inflow (E and A waves), pulmonary venous flow (S, D and Ar waves) and Doppler tissue imaging of the mitral annulus (Ea and Aa waves).ResultsOverall, the linear correlations between the different Doppler measurements were poor. When sub-grouped with respect to E/A < 1 and E/A >= 1 (Groups 1 and 2, respectively), the Ea value did not significantly differ between the two groups: 5.0 cm/s (4.2/6.0) vs 6.2 cm/s (5.5/8. 2) respectively; p = 0.129 and neither did the E/Ea quotient: 10.2 (8.2/14.5) vs 12.9 (9.1/17.4) respectively; p = 0.160. Atrial size was significantly greater in Group 2: 20.0 cm2 (18.0/22.0) vs 25.0 cm2 (20.0/29.0) respectively; p = 0.000. The Ea/Aa quotient was pseudo-normalized in Group 2: 0.65 (0.48/0.83) vs 1.15 (0.75/1.71) respectively; p = 0.001.ConclusionsIn patients with left ventricular systolic dysfunction the Ea/Aa value tends towards pseudo-normalization when the preload is increased. This does not apply to the values of Ea, E/Ea or to size of the left atrium. Therefore, Doppler tissue imaging of the left mitral annulus is valuable in the assessment of left ventricular dysfunction and the problem of pseudo-normalization due to preloading.

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