Skip to main content

Advertisement

SpringerLink
Log in

Comparison of the prognostic value of lateral versus septal early mitral annulus velocity in patients with acute decompensated heart failure

  • OriginalPaper
  • Published:
The International Journal of Cardiovascular Imaging Aims and scope Submit manuscript

Abstract

Mitral annular early diastolic velocity (e′) measured using Doppler echocardiography is important for the noninvasive estimation of left ventricular filling pressure (LVFP). However, it remains unknown whether lateral or septal e′ is prognostically more reliable. Accordingly, here, we compared the prognostic utility of lateral e′ with that of septal e′ in patients hospitalized for acute decompensated heart failure (HF). We retrospectively analyzed the data of 193 consecutive patients with acute decompensated HF. According to the 2016 American Society of Echocardiography/European Association of Cardiovascular Imaging guidelines, the cut-off values of high lateral e′ and septal e′ were 10 cm/s and 7 cm/s, respectively. Kaplan–Meier survival curves and log-rank tests were used to compare 90-day mortality between groups. For the entire cohort, 90-day mortality was 15.5%. Lateral e′ <10 was significantly correlated with higher 90-day mortality (log-rank, P = 0.026), whereas septal e′ <7 was not significantly associated with 90-day mortality (log-rank, P = 0.405). Receiver operating characteristic curve analyses revealed that the best cut-off values for lateral e′ and septal e′ in this cohort were 10 cm/s and 6 cm/s, respectively. However, septal e′ <6 was also not associated with 90-day mortality (log-rank, P = 0.141). This study demonstrated that, when comparing lateral e′ with septal e′, the former provides better prognostic utility for patients with acute decompensated HF. If a dissociation between lateral e′ and septal e′ is detected, the value measured at the lateral site may be more credible for determining LVFP in HF.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Oh JK, Appleton CP, Hatle LK, Nishimura RA, Seward JB, Tajik AJ (1997) The noninvasive assessment of left ventricular diastolic function with two-dimensional and doppler echocardiography. J Am Soc Echocardiogr 10:246–270. https://doi.org/10.1016/s0894-7317(97)70062-2

    Article  CAS  PubMed  Google Scholar 

  2. Nishimura RA, Tajik AJ (1997) Evaluation of diastolic filling of left ventricle in health and disease: doppler echocardiography is the clinician’s Rosetta Stone. J Am Coll Cardiol 30:8–18. https://doi.org/10.1016/s0735-1097(97)00144-7

    Article  CAS  PubMed  Google Scholar 

  3. Sohn DW, Chai IH, Lee DJ, Kim HC, Kim HS, Oh BH, Lee MM, Park YB, Choi YS, Seo JD, Lee YW (1997) Assessment of mitral annulus velocity by Doppler tissue imaging in the evaluation of left ventricular diastolic function. J Am Coll Cardiol 30:474–480. https://doi.org/10.1016/s0735-1097(97)88335-0

    Article  CAS  PubMed  Google Scholar 

  4. Nagueh SF, Middleton KJ, Kopelen HA, Zoghbi WA, Quinones MA (1997) Doppler tissue imaging: a noninvasive technique for evaluation of left ventricular relaxation and estimation of filling pressures. J Am Coll Cardiol 30:1527–1533

    Article  CAS  PubMed  Google Scholar 

  5. Garcia MJ, Thomas JD, Klein AL (1998) New doppler echocardiographic applications for the study of diastolic function. J Am Coll Cardiol 32:865–875. https://doi.org/10.1016/s0735-1097(98)00345-3

    Article  CAS  PubMed  Google Scholar 

  6. Nagueh SF, Smiseth OA, Appleton CP, Byrd BF 3, Dokainish H, Edvardsen T, Flachskampf FA, Gillebert TC, Klein AL, Lancellotti P, Marino P, Oh JK, Popescu BA, Waggoner AD (2016) Recommendations for the evaluation of left ventricular diastolic function by echocardiography: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr 29:277–314. https://doi.org/10.1016/j.echo.2016.01.011

    Article  PubMed  Google Scholar 

  7. Lancellotti P, Galderisi M, Edvardsen T, Donal E, Goliasch G, Cardim N, Magne J, Laginha S, Hagendorff A, Haland TF, Aaberge L, Martinez C, Rapacciuolo A, Santoro C, Ilardi F, Postolache A, Dulgheru R, Mateescu AD, Beladan CC, Deleanu D, Marchetta S, Auffret V, Schwammenthal E, Habib G, Popescu BA (2017) Echo-Doppler estimation of left ventricular filling pressure: results of the multicentre EACVI Euro-Filling study. Eur Heart J Cardiovasc Imaging 18:961–968. https://doi.org/10.1093/ehjci/jex067

    Article  PubMed  Google Scholar 

  8. Balaney B, Medvedofsky D, Mediratta A, Singh A, Ciszek B, Kruse E, Shah AP, Addetia K, Lang RM, Mor-Avi V (2018) Invasive validation of the echocardiographic assessment of left ventricular filling pressures using the 2016 diastolic guidelines: head-to-head comparison with the 2009 guidelines. J Am Soc Echocardiogr 31:79–88. https://doi.org/10.1016/j.echo.2017.09.002

    Article  PubMed  Google Scholar 

  9. Bhella PS, Pacini EL, Prasad A, Hastings JL, Adams-Huet B, Thomas JD, Grayburn PA, Levine BD (2011) Echocardiographic indices do not reliably track changes in left-sided filling pressure in healthy subjects or patients with heart failure with preserved ejection fraction. Circ Cardiovasc Imaging 4:482–489. https://doi.org/10.1161/circimaging.110.960575

    Article  PubMed  PubMed Central  Google Scholar 

  10. Nauta JF, Hummel YM, van der Meer P, Lam CSP, Voors AA, van Melle JP (2018) Correlation with invasive left ventricular filling pressures and prognostic relevance of the echocardiographic diastolic parameters used in the 2016 ESC heart failure guidelines and in the 2016 ASE/EACVI recommendations: a systematic review in patients with heart failure with preserved ejection fraction. Eur J Heart Fail 20:1303–1311. https://doi.org/10.1002/ejhf.1220

    Article  PubMed  Google Scholar 

  11. Matsuo S, Imai E, Horio M, Yasuda Y, Tomita K, Nitta K, Yamagata K, Tomino Y, Yokoyama H, Hishida A (2009) Revised equations for estimated GFR from serum creatinine in Japan. Am J Kidney Dis 53:982–992. https://doi.org/10.1053/j.ajkd.2008.12.034

    Article  CAS  PubMed  Google Scholar 

  12. Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA, Picard MH, Roman MJ, Seward J, Shanewise JS, Solomon SD, Spencer KT, Sutton MS, Stewart WJ (2005) Recommendations for chamber quantification: a report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber quantification writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J Am Soc Echocardiogr 18:1440–1463. https://doi.org/10.1016/j.echo.2005.10.005

    Article  PubMed  Google Scholar 

  13. Wang M, Yip G, Yu CM, Zhang Q, Zhang Y, Tse D, Kong SL, Sanderson JE (2005) Independent and incremental prognostic value of early mitral annulus velocity in patients with impaired left ventricular systolic function. J Am Coll Cardiol 45:272–277. https://doi.org/10.1016/j.jacc.2004.09.059

    Article  PubMed  Google Scholar 

  14. Ommen SR, Nishimura RA, Appleton CP, Miller FA, Oh JK, Redfield MM, Tajik AJ (2000) Clinical utility of Doppler echocardiography and tissue doppler imaging in the estimation of left ventricular filling pressures: a comparative simultaneous doppler-catheterization study. Circulation 102:1788–1794

    Article  CAS  PubMed  Google Scholar 

  15. Firstenberg MS, Levine BD, Garcia MJ, Greenberg NL, Cardon L, Morehead AJ, Zuckerman J, Thomas JD (2000) Relationship of echocardiographic indices to pulmonary capillary wedge pressures in healthy volunteers. J Am Coll Cardiol 36:1664–1669

    Article  CAS  PubMed  Google Scholar 

  16. Rivas-Gotz C, Manolios M, Thohan V, Nagueh SF (2003) Impact of left ventricular ejection fraction on estimation of left ventricular filling pressures using tissue doppler and flow propagation velocity. Am J Cardiol 91:780–784. https://doi.org/10.1016/s0002-9149(02)03433-1

    Article  PubMed  Google Scholar 

  17. Hadano Y, Murata K, Tanaka N, Muro A, Akagawa E, Tanaka T, Kunichika H, Matsuzaki M (2007) Ratio of early transmitral velocity to lateral mitral annular early diastolic velocity has the best correlation with wedge pressure following cardiac surgery. Circ J 71:1274–1278. https://doi.org/10.1253/circj.71.1274

    Article  PubMed  Google Scholar 

  18. Lim HS, Kang SJ, Choi JH, Ahn SG, Choi BJ, Choi SY, Yoon MH, Hwang GS, Tahk SJ, Shin JH (2009) Is E/E’ reliable in patients with regional wall motion abnormalities to estimate left ventricular filling pressure? Int J Cardiovasc Imaging 25:33–39. https://doi.org/10.1007/s10554-008-9340-2

    Article  PubMed  Google Scholar 

  19. Vinereanu D, Khokhar A, Fraser AG (1999) Reproducibility of pulsed wave tissue doppler echocardiography. J Am Soc Echocardiogr 12:492–499. https://doi.org/10.1016/s0894-7317(99)70086-6

    Article  CAS  PubMed  Google Scholar 

  20. Miyoshi T, Addetia K, Citro R, Daimon M, Desale S, Fajardo PG, Kasliwal RR, Kirkpatrick JN, Monaghan MJ, Muraru D, Ogunyankin KO, Park SW, Ronderos RE, Sadeghpour A, Scalia GM, Takeuchi M, Tsang W, Tucay ES, Tude Rodrigues AC, Vivekanandan A, Zhang Y, Blitz A, Lang RM, Asch FM (2020) Left ventricular diastolic function in healthy adult individuals: results of the world alliance societies of echocardiography normal values study. J Am Soc Echocardiogr 33:1223–1233. https://doi.org/10.1016/j.echo.2020.06.008

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

The authors thank Ms. Eri Nagata for her secretarial assistance.

Funding

This work was supported, in part, by grants from the Japan Society for the Promotion of Science (KAKENHI 17K09523 and 21K08109; to K. Matsushita), the Kyorin University School of Medicine (No. B102090002; to K. Matsushita), and the Vehicle Racing Commemorative Foundation (No. 5991 and 6104; to K. Matsushita). The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the preparation, review, or approval of the manuscript; or in the decision to submit the manuscript for publication.

Author information

Authors and Affiliations

  1. Department of Cardiovascular Medicine, Kyorin University School of Medicine, Tokyo, Japan

    Kenichi Matsushita, Toshinori Minamishima, Konomi Sakata, Toru Satoh & Kyoko Soejima

  2. Division of Advanced Cardiovascular Therapeutics, Department of Cardiovascular Medicine, Kumamoto University Hospital, Kumamoto, Japan

    Kenichi Matsushita

Authors
  1. Kenichi Matsushita
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Toshinori Minamishima
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Konomi Sakata
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Toru Satoh
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kyoko Soejima
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

KM: Conceptualization, Data curation, Formal analysis, Funding acquisition, Investigation, Methodology, Project administration, Resources, Supervision, Visualization, and Writing—original draft. TM, KS, TS, and KS: Data curation, Investigation, Resources, Validation, and Writing—review & editing. All authors approved the final version of the manuscript submitted for publication. KM is responsible for the integrity of the overall work.

Corresponding author

Correspondence to Kenichi Matsushita.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study was performed in accordance with the principles of the Declaration of Helsinki. Ethics approval was granted by the Institutional Ethics Review Board of the Kyorin University School of Medicine, Japan.

Consent to participate

Due to the retrospective nature of this study, the need for informed consent was waived by the Institutional Ethics Review Board of the Kyorin University School of Medicine, Japan.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Matsushita, K., Minamishima, T., Sakata, K. et al. Comparison of the prognostic value of lateral versus septal early mitral annulus velocity in patients with acute decompensated heart failure. Int J Cardiovasc Imaging 39, 707–714 (2023). https://doi.org/10.1007/s10554-022-02770-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10554-022-02770-1

Keywords

Search

Navigation