Doppler Echocardiography in Dilated Cardiomyopathy: Diastolic and Combined Systolic/Diastolic Parameters Offer More Detailed Information on Left Ventricular Global Dysfunction than Systolic Parameters

摘要

Although diastolic dysfunction is the initial alteration in dilated cardiomyopathy (DCM), and systolic and diastolic dysfunctions generally coexist during the clinical course of DCM, left ventricular ejection fraction (LV-EF) as an entirely systolic parameter is commonly used to assess LV-function. Several studies have shown greater correlation between clinical status and diastolic echocardiographic parameters. A new index, systolic/diastolic performance [(ICT+IRT)/ET; ICT = isovolumetric contraction time; IRT = isovolumetric relaxation time; ET = ejection time] combines diastolic and systolic parameters and is less influenced by heart rate and mitral regurgitation. The present study was designed to evaluate the accuracy in detecting left ventricular global dysfunction by different echocardiographic measures, in correlation to NYHA-grade and LV-EF (angiography) in DCM.Left ventricular end diastolic diameter (LVEDD), LV-EF, A-, E-dec.-time, and systolic/diastolic performance were obtained by Doppler echocardiography and compared to NYHA-grade and LV-EF (angio) in 68 patients with DCM. LV-EF (echo) values were dispersed widely and showed no correlation to NYHA-grade. In contrast LV-EF (angio), LVEDD, E-, A-dec.-time, and systolic/diastolic performance showed a high correlation to NYHA-grade.The successive shortening of E/A-dec.-time due to increasing LV filling pressures and the increasing systolic/diastolic performance contribute more detailed information about clinical status and can be carried out quickly and non-invasively.