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To detect and determine severity of left ventricular diastolic dysfunction (LV DD) one need to utilize instrumental methods of diagnostics, especially Doppler echocardiography. We have shown earlier that reflected high intensity motion signals (RIMS), obtained by conventional pulsed wave Doppler, can be used for detection of LV DD. The aim of this study is to analyze whether simple conventional Doppler E/e ratio (where E is a peak velocity of transmitral flow and e is a maximal velocity of early diastolic component of RIMS) can be utilized for differentiation of normal LV filling and mild DD from severe DD.
72 subjects (mean age 55.7±9.2, male 48) underwent Doppler Echocardiography. DD degree was identified according to ASE/EACVI guidelines (2016). In 27 subjects LV filling was normal (1-st group), in 20 patients there were signs of DD 1-st degree (2-d group) and in 25 of 2-3 degree (3-d group). To obtain RIMS cardiac probe was placed in apical position and the sample volume was moved 3 cm lateral to the left border of mitral annulus. Mean values of E/e ratio in subjects of three groups were compared. Sensitivity and specificity of E/e in separation of patients with DD 2-3 degree from subjects with normal LV filling and DD 1-st degree were determined.
Mean value of E/e ratio in subjects of 1-st group was 2.93±0.57 and did not differ significantly from E/e ratio in 2-d group (3.27±0.80; p1-2=0.10). Mean value of E/e in 3-d group (4.84±1.69) was significantly higher than in 1-st and 2-d groups (p1-3<0.0001, p2-3=0.0004). The cutoff value of E/e>3.7 differentiated subjects with normal LV filling and mild DD from patients with severe DD with sensitivity 86.3% and specificity 86.7%.
Normal value of E/e ratio was determined (2.93±0.57). New simple Doppler E/e ratio can effectively help in differentiation of normal LV filling and mild DD from severe DD (cutoff value >3.7).