Shortened mitral A wave deceleration time: An under-recognized but promising Doppler-derived index of left ventricular myocardial dysfunction in patients with normal left ventricular ejection fraction

摘要

Heart failure represents a major worldwide health problem, and near half of patients presenting with signs and symptoms suggestive of this condition have a normal left ventricular ejection fraction. Establishing the diagnosis of heart failure with a normal ejection fraction is a challenge for physicians and requires comprehensive Doppler echocar-diography. Given the inherent limitations in terms of feasibility, reproducibility and accuracy, the validation of new Doppler indexes is of crucial importance to reinforce the diagnostic algorithms. The Doppler-derived deceleration time of late mitral filling (DTA) is a user-friendly index that has been reported highly feasible and reproducible [1]. Furthermore, some evidence suggests its close relation to invasively recorded left ventricular end-diastolic pressures [1-3]. However, its usefulness in the prediction of myocardial dysfunction has not been addressed in patients with a normal ejection fraction.