USEFULNESS OF MITRAL ANNULAR SYSTOLIC VELOCITY IN THE DETECTION OF LEFT VENTRICULAR SYSTOLIC DYSFUNCTION: COMPARISON WITH THREE DIMENSIONAL ECHOCARDIOGRAPHIC DATA

Background: Although the modified Simpson's method is widely used for the assessment of left ventricular ejection fraction (LVEF), it has limitations including relatively high inter- and intra-observer variability and time consuming nature. We want to evaluate whether assessing mitral annular systolic velocity (S' velocity) by tissue Doppler imaging (TDI) can be used to evaluate LV systolic function with comparing LVEF by three dimensional echocardiography (3DE). Methods: We examined 3DE and TDI studies of patients between January and August 2008. 3DE LVEF was measured by offline commercial computer software EchoPac $PC^{(R)}$ (GE, Andover, MA, USA). S' velocity was obtained from the medial side with apical four chamber view by pulsed-wave Doppler with TDI. Results: We included 125 patients (78 males (62.4%), mean age: 57.5${\pm}$13.0 years). The mean S' velocity was 7.7${\pm}$1.9 cm/s and the mean LVEF was 57.2${\pm}$10.4%. The S' velocity measured by TDI showed a linear correlation with LVEF measured by 3DE (r=0.688, p<0.001). Study patients were divided into two groups according to the presence of LV systolic dysfunction: Group I (normal LVEF), n=102 and Group II (LVEF <50%), n=23. For prediction of significant LV systolic dysfunction by the receiver operating characteristic curve according to S' velocity, the optimal cutoff value was 6.8 cm/s. At this cutoff value, the sensitivity and specificity were 94.1% and 87%, respectively. Conclusion: In this study, S' velocity measured by TDI showed a significant correlation with three dimensional LVEF and can be used to detect patients with LV systolic dysfunction.