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A Journal on Heart and Vascular Diseases
Official Journal of the Italian Society of Angiology and Vascular Pathology
Indexed/Abstracted in: EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 0,752
CASE REPORTS PEDIATRIC HEART FAILURE
Minerva Cardioangiologica 2008 June;56(3):371-5
Triphasic diastolic pattern and delayed timing of myocardial relaxation identify dynamic changes of left ventricular filling pressure
Schiano Lomoriello V., Esposito R., Marzano A., Raia R., Galderisi M.
Cardioangiology Unit with CCU Department of Clinical and Experimental Medicine Federico II University Hospital, Naples, Italy
The case reported concerns a woman with hypertensive emergency, showing triphasic diastolic pattern with mid-diastolic velocity both at transmitral inflow and at pulsed tissue Doppler-derived septal/lateral mitral annulus. In addition, the time from EKG R wave peak to annular early diastolic velocity (Em) onset was longer than the time occurring between R peak and transmitral E velocity. E/Em ratio was 14.6 and left atrium enlarged. After blood pressure fall and clinical stabilization, the triphasic diastolic patterns were again observed. However, the timing of early diastolic velocity was the same at mitral inflow and annular tissue Doppler. E/Em ratio and left atrial volume were reduced. The present report highlights the additional value of pulsed tissue Doppler to detect alteration of diastolic properties and dynamic changes of left ventricular filling pressure.