Discussion of Doppler tissue imaging on mitral annulus in patient with coronary artery disease

Objective The aim of this study is to assess global LV systolic and diastolic function in patients with CAD using a new technology called Doppler Tissue Imaging (DTI) on the motion of mitral annulus Methods Thirty-two patients with CAD and 20 normal subjects as control group were included, 6 mitral annular sites: septal and lateral from apical 4-chamber views, anterior and inferior from apical 2-chamber view, anteroseptum and posterior from apical 3-chamber views were adopted. The peak systolic and peak early and late diastolic velocities of each of 6 mitral annular site were measured (Sa, Ea, Aa, respectively). Results 1. The spectrum pattern are similar in CAD patients and normal group with three main waves in each cardiac cycle :Sa in systolic and Ea、Aa in diastolic 2. The peak velocity of Sa, Ea and Ea/Aa ratio of each of 6 mitral annular site are significantly lower in CAD patients than normal subjects (P0.01) 3. In patients with CAD there were close relations between the 6-site average Sa of the mitral annulus and LVEF(r=0.689,P0.01), and between the average Ea/Aa of mitral annulus and thrasmitral indexes E/A ratio (r=0.42 P0.05) 4. The Sa of the lateral site of mitral annulus from the apical 4-chamber view correlated most closely with the average Sa in both normal subjects (r=0.774)and CAD patients (r=0.812),the same as the relationship the Ea/Aa ratio of the lateral site of the mitral annular and average Ea/Aa ratio (r=0.562, r=0.585,respectively) Conclusion Mitral annular motion spectrum derived from DTI can reflect systolic and diastolic dysfunction at the same time. It is a new, safe, direct, reliable and easy manner.