Factors associated with mitral annular systolic and diastolic velocities in healthy adults

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Abstract

Background

Measurements of systolic mitral annular velocity (S′), early diastolic mitral annular velocity (E′), and late diastolic mitral annular velocity (A′) are used to assess left ventricular (LV) function.

Objective

We sought to investigate the relationship between septal and lateral annular velocities and determine whether these velocities are related to body size (including body mass index [BMI]), heart rate (HR), blood pressure, or LV mass.

Methods

A total of 60 healthy participants who were normotensive, between age 20 and 52 years, underwent standard echocardiography and measurement of septal and lateral S′, E′, and A′.

Results

The lateral velocity exceeded the septal velocity for S′, E′, and A′. There was only weak to moderate correlation between the velocities at the two sites (r = 0.43-0.60). Septal S′ was positively correlated with height and HR, and lateral S′ was correlated with HR. Septal E′ was negatively correlated with age, BMI, LV mass, and diastolic blood pressure, but lateral E′ was only negatively correlated with age and BMI. Septal A′ was positively correlated with age, HR, and BMI, whereas lateral A' was only positively associated with age.

Conclusions

S′, E′, and A′ are not only of different magnitudes at the septal and lateral sites, but are not closely correlated. There are relationships between annular velocities and body size, HR, blood pressure, and LV mass that differ between the septal and lateral annulus, providing a possible explanation for the lack of close correlation in these velocities and suggesting that these variables may need to be considered when interpreting annular velocities.

Section snippets

Participants

The study design was approved by the institutional human research and ethics committee and written consent was obtained from the participants. The study group comprised 60 healthy participants between the ages of 20 and 52 years (mean age, 33 ± 8 years), half of whom were men. Participants were not eligible if they had a history of cardiac disease or hypertension. Height and weight were measured immediately before the echocardiographic study. Body surface area (BSA) was calculated using the

Participant group characteristics

In our cohort, participant height ranged from 156 to 195 cm, weight ranged from 49 to 101 kg, systolic BP ranged from 85 to 130 mm Hg, diastolic BP ranged from 50 to 90 mm Hg, and HR ranged from 42/min to 92/min. Of the derived measurements, BSA ranged from 1.47 to 2.34 m2, BMI ranged from 18.4 to 28.7 kg/m2, and LV mass ranged from 80 to 292 g.

The univariate correlations of LV end-diastolic diameter (LVEDD), LV mass, LV mass/height, LV mass/height2.7, and LV mass/BSA with age, sex, BP, and

Discussion

In this study, performed in a healthy cohort of participants between 20 and 52 years without cardiac disease, obesity, or hypertension, we examined the relationship among S′, E′, and A′ at the septal and lateral annulus and also the association of S′, E′, and A′ with body size, HR, BP, and LV mass. There were 4 important new findings of this study. First, not only did we confirm previous reports that the S′, E′, and A′ at the septal annulus are significantly lower than the lateral annulus, but

References (43)

  • Y.J. Kim et al.

    Mitral annulus velocity in the estimation of left ventricular filling pressureprospective study in 200 patients

    J Am Soc Echocardiogr

    (2000)
  • M.J. Garcia et al.

    Differentiation of constrictive pericarditis from restrictive cardiomyopathyassessment of left ventricular diastolic velocities in longitudinal axis by Doppler tissue imaging

    J Am Coll Cardiol

    (1996)
  • B.M. Richartz et al.

    Comparison of left ventricular systolic and diastolic function in patients with idiopathic dilated cardiomyopathy and mild heart failure versus those with severe heart failure

    Am J Cardiol

    (2002)
  • R.B. Devereux et al.

    Echocardiographic assessment of left ventricular hypertrophycomparison to necropsy findings

    Am J Cardiol

    (1986)
  • G. de Simone et al.

    Left ventricular mass and body size in normotensive children and adultsassessment of allometric relations and impact of overweight

    J Am Coll Cardiol

    (1992)
  • T. Oki et al.

    Effect of an acute increase in afterload on left ventricular regional wall motion velocity in healthy subjects

    J Am Soc Echocardiogr

    (1999)
  • L. Rodriguez et al.

    Assessment of mitral annular dynamics during diastole by Doppler tissue imagingcomparison with mitral Doppler inflow in subjects without heart disease and in patients with left ventricular hypertrophy

    Am Heart J

    (1996)
  • R.G. Pai et al.

    Usefulness of systolic excursion of the mitral annulus as an index of left ventricular systolic function

    Am J Cardiol

    (1991)
  • K. Emilsson et al.

    The relation between mitral annulus motion and ejection fractiona nonlinear function

    J Am Soc Echocardiogr

    (2000)
  • V.K. Munagala et al.

    Association of newer diastolic function parameters with age in healthy subjectsa population-based study

    J Am Soc Echocardiogr

    (2003)
  • S. Chakko et al.

    Abnormal left ventricular diastolic filling in eccentric left ventricular hypertrophy of obesity

    Am J Cardiol

    (1991)
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