Mitral annular tissue velocity in the diagnosis of coronary artery disease

Non-invasive methods of coronary disease detection are immediately needed. Recent work suggested that mitral annular tissue velocity measurements could be helpful for assessing left ventricular function. We aim to determine the effect of coronary artery lesion on left ventricular function using tissue Doppler imaging (TDI), and to discuss the role of mitral annular tissue velocity in the diagnosis of coronary heart disease (CHD).

Coronary angiographic examinations were conducted for 68 patients with suspected CHD. Left ventricular ejection fraction (LVEF), early diastolic mitral flow velocity E, late diastolic mitral flow velocity A, mean systolic (Sa) and mean early diastolic velocity (Ea) of the septal and lateral mitral annulus were measured before the angiographic examination. Patients were grouped according to the number of branches with ≥ 50% stenosis. The control group has 15 individuals. The remaining 53 patients with stenosis in 1, 2 and 3 branches were grouped into 1-Branch, 2-Branch, 3-Branch-Light-Condition and 3-Branch-Heavy-Condition groups, respectively. No significant differences in the other general health parameters of the patients were found.

There was no significant difference in LVEF and E/A but in Sa, Ea and E/Ea values between CHD and non-CHD patients. The E/Ea value was significantly elevated in CHD patients, aggravated by this pathological condition. The area bounded by the ROC (receiver operating characteristic) curve of E/Ea is the largest. The sensitivity and specificity of using E/Ea > 8.34 as the diagnostic criterion to pinpoint CHD were 77.4% and 100%, respectively.

E/Ea is a good indicator of diastolic function and can be useful to diagnose CHD.