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Title: Lateral vs medial mitral annular tissue Doppler in the echocardiographic assessment of diastolic function and filling pressures: which should we use?
Austin Authors: Srivastava, Piyush M ;Burrell, Louise M ;Calafiore, Paul 
Affiliation: Department of Medicine, University of Melbourne, Austin Health, Burgundy Street, Heidelberg, Melbourne, Victoria 3084, Australia
Issue Date: 1-Mar-2005
Publication information: European Journal of Echocardiography : the Journal of the Working Group On Echocardiography of the European Society of Cardiology; 6(2): 97-106
Abstract: Tissue Doppler echocardiography (TDE) is used in the assessment of diastolic function, however, it is unclear whether the medial (E' med) or lateral (E' lat) annulus should be used. Our aim was to compare the diagnostic utility of E' med and E' lat. In 232 subjects left ventricular (LV) systolic and diastolic function was assessed via transthoracic echocardiography with TDE measurements obtained from both annuli. LV function was normal in 91 subjects (39%), with diastolic dysfunction found in 141 subjects (61%). TDE velocities decreased with age and progressive diastolic dysfunction for either annulus. E' med recorded significantly lower myocardial velocities than E' lat. Receiver operator curves showed improved area under the curve (AUC) for E' med than E' lat. Furthermore the AUC was significantly improved compared to E/A ratio and deceleration time. For diagnosing diastolic dysfunction, an E' med<11cm/s provided a sensitivity of 78%, specificity of 67% and positive predictive value of 70%. Whilst for diagnosing elevated filling pressures an E/E' medial ratio>8 provided values of 56%, 93% and 91%, respectively. In conclusion, although either annulus can be used, E' med provides better diagnostic utility.
Gov't Doc #: 15760686
DOI: 10.1016/j.euje.2004.07.005
Type: Journal Article
Subjects: Aged
Area Under Curve
Echocardiography, Doppler.methods
Middle Aged
Mitral Valve
Predictive Value of Tests
ROC Curve
Sensitivity and Specificity
Ventricular Dysfunction, Left.ultrasonography
Ventricular Function, Left.physiology
Appears in Collections:Journal articles

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