Diastolic mitral annular motion in normal subjects and patients with coronary artery disease

Area of Science:

• Cardiology
• Echocardiography
• Diastolic Function

Background:

• Mitral annular motion reflects left ventricular diastolic function.
• Myocardial infarction (MI) can impair diastolic mechanics.
• Understanding diastolic mitral annular motion is crucial for assessing cardiac health.

Purpose of the Study:

• To evaluate mitral annular motion characteristics during diastole in normal subjects and patients with prior MI or coronary artery disease.
• To investigate determinants of early (MAE-E) and late (MAE-L) diastolic mitral annular excursion.
• To compare these parameters among different patient groups and correlate them with transmitral flow patterns.

Main Methods:

• M-mode echocardiography at the left ventricular posterior wall apex to assess mitral annular motion.
• Doppler echocardiography to obtain transmitral flow velocity-time integrals (EI, AI).
• Analysis of MAE-E, MAE-L, MAE-L:MAE-E ratio, and AI:EI ratio in normal subjects and patients.

Main Results:

• MAE-E was primarily determined by heart rate and left ventricular ejection fraction (LVEF).
• MAE-L was solely determined by age.
• MAE-E was significantly reduced in prior MI patients compared to controls (P < 0.01).
• MAE-L did not differ significantly among groups.
• The MAE-L:MAE-E ratio was higher in prior MI patients (P < 0.05) and correlated with the AI:EI ratio in both healthy volunteers (r=0.65) and MI patients (r=0.50).

Conclusions:

• Prior MI significantly impacts early diastolic mitral annular excursion.
• The MAE-L:MAE-E ratio serves as a valuable index of diastolic function, particularly in patients with prior MI.
• This ratio shows a significant correlation with transmitral flow dynamics, offering insights into diastolic filling patterns.