The Effectiveness of Intraventricular Pulsed Doppler E-Wave Dispersion in Assessing Diastolic Functions of Patients with Atrial Fibrillation

Abstract

Objectives: We investigated the effectiveness of intraventricular E-wave dispersion in assessing diastolic functions in patients with atrial fibrillation. Study design: The study included 51 patients (32 females, 19 males; mean age 66 +/- 10 years) with atrial fibrillation. The patients were divided into two groups according to the presence (n=31; 60.8%) or absence (n=20; 39.2%) of diastolic dysfunction defined by propagation velocities (Vp) of <0.45 m/s and >= 0.45 m/s, respectively, determined by color M-mode Doppler echocardiography. Regional peak E-wave velocities were measured with pulsed wave Doppler echocardiography at every 1 cm from the mitral valve annulus to the left ventricular apex. Results: The highest and the lowest E-wave velocities were measured at E-1 position (E velocity at 1 cm) and at E-3 position (E velocity at 3 cm) in both groups, respectively. E-2 and E-3 velocities were significantly lower in patients with diastolic dysfunction (p<0.01 and p<0.001, respectively). It was noted that, in patients without diastolic dysfunction, the E-wave velocity measured at the mitral annulus was preserved even 3 cm away from the annulus in the left ventricular cavity (E-0: 0.93 +/- 0.21 m/sec, E-3: 0.87 +/- 0.25 m/sec; p=0.166). In contrast, regional E-wave velocities decreased significantly toward the apex in patients with diastolic dysfunction (E-0: 0.87 +/- 0.20 m/sec, E-3: 0.66 +/- 0.18 m/sec; p<0.001). Conclusion: Our results demonstrate that intraventricular E-wave dispersion may be helpful in determining diastolic dysfunction in patients with atrial fibrillation.