Abstract: Objective To evaluate the accuracy of the time interval between the onset of early transmitral flow velocity (E) and
that of early diastolic mitral annular velocity (e’) (TE-e’) measured by dual Doppler echocardiography in the diagnosis of
diastolic dysfunction. Methods Seventy-seven coronary heart disease patients with preserved systolic function underwent a
echocardiographic study. Early transmitral flow velocity E and early diastolic mitral annular velocity e’ were simultaneously
recorded by dual Doppler echocardiography. The E/e’ and TE-e’ were calculated and compared with the left ventricular end
diastolic pressure (LVEDP), which was measured invasively. The validity of TE-e’, E/e’ and their combination was analyzed in
estimating left ventricular dysfunction (LVEDP ≥12 mmHg). Results The single-beat E/e’ and TE-e’ were correlated with the
LVEDP (r=0.79 and 0.42, respectively, P<0.001). Receiver-operating characteristic analysis showed that the optimal cut-off for
TE-e’ was 38 ms (sensitivity 54%, specificity 79%, AUC 0.71) and that for E/e’ was 9.2 (sensitivity 74%, specificity 81%, AUC 0.87)
for diagnosis of left ventricular diastolic dysfunction. The combined cut-offs of TE-e’ ≥38 ms and E/e’ ≥9.2 had a sensitivity of
100% and a specificity of 62% in diagnosing left ventricular diastolic dysfunction with an AUC of 0.96. Conclusion In patients
with coronary heart disease, the simultaneous recording of TE-e’ by dual Doppler echocardiography can accurately estimate
diastolic dysfunction, and its combination with E/e’ can further improve the diagnostic accuracy.