Assessment of left ventricular diastolic function using color kinesis: differentiation between normal and...

Area of Science:

• Cardiology
• Echocardiography
• Diastolic Function Assessment

Background:

• Transmitral flow Doppler assesses left ventricular (LV) diastolic function but can be confounded by increased left atrial pressure, leading to pseudonormalization.
• Distinguishing normal from pseudonormalized LV inflow patterns is crucial for accurate diastolic function evaluation.

Purpose of the Study:

• To evaluate the utility of diastolic color kinesis (CK) analysis for differentiating normal from pseudonormalized (PN) LV inflow patterns.
• To assess if CK can identify delayed early diastolic relaxation.

Main Methods:

• Sixty subjects with an E/A ratio > 1.0 were studied using Doppler echocardiography, tissue Doppler imaging (e'), and LV ejection fraction (EF) calculation.
• Subjects were categorized into normal, PN1 (preserved EF), and PN2 (impaired EF) groups.
• Diastolic CK images were analyzed using ICK software to calculate the CK-diastolic index (CK-DI), representing LV segmental filling fraction.

Main Results:

• Mean CK-DI was significantly lower in PN1 (46.3% ± 10.4%) and PN2 (36.3% ± 5.1%) groups compared to the normal group (70.9% ± 6.5%).
• CK-DI was significantly reduced in PN2 compared to PN1, despite similar e' values between pseudonormalized groups.
• Reduced CK-DI was observed in pseudonormalized patients with both preserved and impaired LV systolic function.

Conclusions:

• Diastolic CK analysis with ICK software is a valuable tool for detecting delayed early diastolic relaxation.
• Diastolic CK imaging can effectively differentiate between normal and pseudonormalized LV inflow patterns.