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Clinical significance of early‐diastolic tissue velocity imaging of lateral mitral annulus for prognosis of nonischemic left ventricular dysfunction
Author(s) -
Kim Hyungseop,
Kim InCheol,
Choi SangWoong,
Chung JinWook,
Kim Jin Young
Publication year - 2019
Publication title -
journal of clinical ultrasound
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.272
H-Index - 61
eISSN - 1097-0096
pISSN - 0091-2751
DOI - 10.1002/jcu.22787
Subject(s) - medicine , cardiology , ejection fraction , heart failure , diastole , magnetic resonance imaging , mitral annulus , cardiac magnetic resonance imaging , basal (medicine) , radiology , blood pressure , insulin
Purpose We explored the potential of tissue velocity imaging (TVI) for prognosis of nonischemic left ventricular (LV) dysfunction (LVD). Methods We reviewed 138 nonischemic LVD patients (58 ± 14 years) who underwent both cardiac magnetic resonance (CMR) and echocardiography. Septal and lateral mitral annular TVI data were compared with late gadolinium enhancement (LGE) on CMR. During a mean follow‐up of 24 months, recovery (>15%) of LV ejection fraction and clinical outcomes (cardiovascular death and heart failure hospitalization) were assessed. Results LGE was commonly observed in the basal anteroseptal, inferoseptal, and inferior segments, but infrequently observed in the anterolateral segment. LGE was associated with lower early diastolic, septal (Sep‐e′ = 5.2 ± 2.0 vs 6.9 ± 2.0 cm/s, P = .031) and lateral (Lat‐e′ = 7.3 ± 3.0 vs 9.5 ± 2.0 cm/s, P < .001) TVI. The relationship between Lat‐e′ and anterolateral LGE (area under the curve, AUC 0.834) was much better than that between Sep‐e′ and inferoseptal LGE (AUC 0.699). The 60 patients with LVD reversibility revealed higher Lat‐e′ (9.8 ± 2.0 vs 6.7 ± 2.2 cm/s, P < .001) and lower LGE burden (7.3 ± 9.0 vs 22 ± 10%, P < .001), while Lat‐e′ ≤ 7.8 cm/s appeared unfavorable for 31 events patients. On multivariate analyses, Lat‐e′ (HR 0.79, 95% CI 0.63‐0.99, P = .044) and LVD reversibility (HR 0.53, 95% CI 0.16‐0.90, P = .018) were still meaningful together with LGE segments and burden. Conclusion Lat‐e′ was related with LVD reversibility and a significant predictor of clinical outcomes.