Letter to the Editor Mitral A-wave deceleration time. A marker of left ventricular diastolic dysfunction following acute myocardial infarction?

Left ventricular (LV) diastolic dysfunction is a prominent cause of several cardiac symptoms and signs, even in patients with normal LV systolic function [1]. Analysis of the mitral inflow and pulmonary venous velocity curves, has been widely used for the noninvasive assessment of LV filling abnormalities [2,3]. Although novel methods as the tissue-Doppler and color m-mode echocardiography have provided useful insights into the study of diastolic dysfunction, none of the parameters, conventional or not, succeeded to detect accurately the type of LV diastolic dysfunction individually. It seems that technology advances overtook the late mitral inflow A-wave deceleration time (Adt), a simple parameter for the prediction of elevated LV end-diastolic pressure [4,5]. The present study aimed to investigate the behavior and clinical value of Adt for the detection of the type of LV diastolic dysfunction in patients with acute myocardial infarction (AMI), a field still lacking in data. One hundred five (77 males) patients of mean age 60 T10 years with first AMI were enrolled in the study. Based on the severity of the Doppler-echocardiographic LV diastolic dysfunction [2,3] they were categorized into four groups: (a) 25 patients with preserved normal diastolic function (NDF), (b) 36 with decreased peak filling rate pattern (DFR), (c) 33 with impaired relaxation pattern (IR) and (d) 11 patients with pseudonormal or restrictive physiology pattern (PN/ RP). Transmitral and pulmonary flow velocity patterns were