Baseline Echocardiography and Diastolic Function Assessment
All patients underwent resting transthoracic echocardiography (TTE) for analysis of LV function, assessment of LV diastolic function and exclusion of existing valvular pathologies using standard echocardiographic views. Early diastolic transmitral filling velocity (E) was measured at the mitral valve leaflets tips using pulsed-wave doppler while spectral tissue doppler imaging was used to measure early diastolic relaxation velocities (e’) at the septal mitral annulus from the apical four-chamber window as previously described.8 LV diastolic function was measured using septal mitral annular E/e’ ratio (the ratio between early mitral inflow velocity and mitral annular early diastolic velocity). Elevated LV filling pressures were defined as septal mitral annular E/e’ ratio ≥ 15.8