Assessment of early diastolic left ventricular function by two-dimensional echocardiographic speckle tracking

Aims To determine whether the degree of untwisting of the apex in early diastole is related to established parameters of diastolic function. Methods and results Data from 71 hospital inpatients with preserved left ventricular systolic function who underwent standard two-dimensional echocardiography was analysed using an off-line speckle tracking software package. Early diastolic mitral inflow velocity (e), mitral septal annular tissue Doppler velocity (e'), and the rate of early diastolic apical untwist in degrees per second (rotR) from a parasternal short-axis view of the apex were all measured. Of the 71 patients, 14 had normal diastolic function, 25 had an abnormal relaxation pattern, 27 had a pseudonormalized pattern, and 5 had a restrictive pattern as defined by standard echocardiography criteria. Both e' and the ratio of e:e' correlated with the rate (speed) of early diastolic apical untwist (rotR) (P < 0.001 for both). Conclusion This non-invasive assessment of apical diastolic untwist is related to established echocardiographic measures of diastolic function and may illustrate the importance of a ventricular suction effect in varying left ventricular filling states.