Hemodynamic determinants of the mitral annulus diastolic velocities by tissue Doppler
Sherif F. Nagueh, MD, FACCa,
Huabin Sun, MDa,
Helen A. Kopelen, RDMSa,
Katherine J. Middleton, RCTa and
Dirar S. Khoury, PhDa
a Department of Medicine, Cardiology Section, Baylor College of Medicine, Houston, Texas, USA
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Figure 1 Lateral corner annular velocities at baseline and after interior vena caval (IVC) occlusion. Notice the decrease in early diastolic annular velocity (Ea) after IVC occlusion. Aa = late diastolic annular velocity.
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Figure 2 Septal corner annular velocities at baseline and after inferior vena caval (IVC) occlusion in another dog. Notice the minimal changes in early diastolic annular velocity (Ea). Aa = late diastolic annular velocity.
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Figure 3 Lateral annular velocities at baseline, with dobutamine and with esmolol. Note the increase of the velocities with dobutamine and their reduction with esmolol. Aa = late diastolic annular velocity; Ea = early diastolic annular velocity.
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Figure 4 Relation of lateral annular Ea to tau (left: R2 = 0.69), LV –dP/dt (middle: R2 = 0.64) and LV minimal pressure (right: R2 = 0.55) in all experimental stages (n = 70). Ea = early diastolic annular velocity; LV = left ventricular.
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Figure 5 Lateral Ea versus maximal instantaneous transmitral pressure gradient divided according to tau. The solid line and solid circles show the relation in one group where tau was <50 ms (y = 3.9 + 0.5x, [R2 = 0.46, p < 0.01]). The dashed line and open circles show the relation where tau was  50 ms (y = 4.8 – 0.02x, R2 = 0.0013, p = 0.5). Ea = early diastolic annular velocity.
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Figure 6 Lateral Ea versus tau in two groups of points divided according to left atrial v wave pressure. The dashed line and open circles (y = 11– 0.08x, R2 = 0.75, p < 0.001) show the data where the left atrial v wave pressure was 10 mm Hg. The solid line and solid circles (y = 9.3– 0.06x, R2 = 0.6, p < 0.001) show the relation where the pressure was <10 mm Hg. Ea = early diastolic annular velocity.
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Figure 7 Relation of lateral Aa velocity to LA dP/dt (left); to LVEDP (middle) and to LA relaxation index (right). Aa = late diastolic annular velocity; dP/dt = the first derivatives of LA pressure; LA = left atrial; LVEDP = left ventricular end-diastolic pressure.
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