Left Ventricular Diastolic Longitudinal Strain Angle as a Parameter (New Tool) to Predict Left Ventricular Diastolic Function

Abstract

Aim: Currently, left ventricular diastolic dysfunction (LVDD) is evaluated using indirect parameters derived from trans-mitral valve inflow velocity (TMIV), pulmonary vein flow, and LV diastolic annular tissue velocity (DATV). None of these parameters is obtained directly from the LV global myocardium. This study aimed to examine the relationship between left ventricular (LV) global longitudinal diastolic strain curve angle (DSCA), which directly assesses myocardial function, and TMIV and DATV parameters, and to determine whether DSCA can serve as a new tool for detecting LVDD. Material and Methods: 114 patients with sinus rhythm were included in the study. Conventional pulse wave Doppler parameters [TMIV E and A peak velocity, E/A ratio (E/AR), deceleration time (DT), deceleration slop (DS)], DATV parameters [Septal é (Sé), E/Septal é ratio (E/SéR)], and DSCA parameters, including early (EεA) and late (AεA) diastolic strain angles and their ratio (Eε/AεAR) obtained from apical 2, 4 and 5 apical chamber views (ACV) were compared. Results: A significantly positive strong correlation was found between Eε/AεAR and E/AR, E/SéR on all views (r=0.620, r=0.548, r=0.570, and r=-0.431, r=-0.279, r=-0.255, respectively). Also, a significantly positive correlation was found between the EεA and E velocity, Eε/AεAR, DS on all views, and, except for A4CV, a significantly negative correlation was found between AεA and E velocity, DS on A2CV and A5CV. Conclusion: The EεA, AεA, and Eε/AεAR are a simple, repeatable, useful and new tool for the evaluation of LVDD, and they can be used alone or together with conventional diastolic parameters for the assessment of LVDD.

Keywords

• left ventricle
• diastolic dysfunction
• transmitral inflow velocity
• strain
• Eε
• and Aε angle
• Eε and Aε angle ratio

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