Detection of Left Ventricular Diastolic Dysfunction Grade Ii-Iii by New Dopplerographic Ratio E/El

ASE/EACVI Guidelines (2016) recommend to use Tissue Doppler (TD) ratio E/e’ for identifying diastolic dysfunction (DD) grade II-III. Earlier we have demonstrated that diastolic component el of Reflected High Intensity Motion Signals (RIMS) can be used for detection of DD when TD is not available. In this study we aimed to analyze if E/el ratio can be utilized for detection of DD II-III grade. We analyzed Dopplerechocardiographic data of 49 subjects. According to ASE/ESCVI Guidelines in 27 subjects (1-st group, healthy persons, mean age 58.6 years) normal left ventricular filling was found; in 22 patients with coronary artery disease (2-d group, mean age 48.6 years) DD grade II-III (pseudonormal and restrictive filling) was detected. RIMS were registered by conventional pulsed wave Doppler from apical 4-chamber view when the sample volume was positioned 2 cm outward from the lateral border of mitral valve. Sensitivity and specificity of E/el ratio in detection of DD grade II-III was determined. In subjects of 1-st group mean value of E/el was 2.93 ± 0.57 and in 2-d group 4.90 ± 1.79 (p = 0.000002). The cutoff value of E/el > 3.5 can detect DD grade II-III with sensitivity 86.4% and specificity 92.6%. New E/el ratio gives opportunity to discriminate normal left ventricular filling from pseudonormal and restrictive and to detect effectively patients with DD grade II-III in cases when TD is unavailable.