A comparison of left ventricular myocardial velocity in diastole measured by magnetic resonance and left ventricular filling measured by Doppler echocardiography

Abstract

Abnormal diastolic left ventricular function is an early marker for myocardial disease and may be impaired even when global systolic function is normal. Subendocardial function is affected early in ischaemic heart disease and by altering left ventricular long axis motion, may contribute to abnormal transmitral pressure gradients. Regional myocardial long axis velocity in diastole measured by magnetic resonance was compared with left ventricular filling measured by Doppler echocardiography in 25 patients with coronary artery disease. Fifteen patients also underwent magnetic resonance assessment at the time of onset of early diastolic blood flow. The onset of diastolic long axis velocity preceded flow across the mitral valve by a mean of 46 ms. Mean long axis myocardial velocity correlated with peak early filling velocity (E) (r = 0.73, P < 0.001), early deceleration (r = -0.73, P < 0.001), and the early to late filling ratio (E/A) ratio (r = 0.6, P < 0.01). Maximum myocardial long axis velocity also correlated with peak early filling velocity (r = 0.56, P < 0.01), early deceleration rate (r = 0.63, P < 0.001), and the E/A ratio (r = 0.53, P < 0.01). The variability of long axis velocity around the ventricle correlated inversely with peak early filling, (r = -0.7, P < 0.001), early deceleration (r = -0.56, P < 0.01), and the E/A ratio (r = -0.48, P < 0.02). Peak atrial filling velocity did not correlate with any measure of long axis myocardial velocity. We conclude that early diastolic long axis myocardial velocity has a significant effect on left ventricular filling.