Abstract 18208: Intraindividual Variation of Tissue Doppler Velocities as Predictors of Cardiac Events in the General Population

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Introduction: Despite of Tissue Doppler imaging (TDI) being an important diagnostic tool for early detection of reduced myocardial function, there is still not a clear consensus on the site of measurement. It is complicated by the fact that the velocities vary between sites even within healthy individuals. Objectives: The aim of this study was to evaluate the predictive value of each mitral site along with the predictive value of the intraindividual variation between sites with respect to cardiac events. Methods: Cardiac function was evaluated by TDI in 2,064 participants within a large community-based population study. Peak systolic (s’), early diastolic (e’) and late diastolic (a’) velocities were obtained from 6 mitral annular sites. To assess global variation, two parameters were calculated using all 6 sites. One as their standard deviation divided by their mean, the other as their range divided by their median. To assess the variation within each apical projection, the difference between its two sites was divided by their mean. The end point was combined of admission with acute myocardial infarction, heart failure or cardiac death. Results: During a median follow-up of 10.9 years the endpoint occurred in 277 participants. In multivariable Cox proportional hazards regression adjusted for age and sex we found that a decrease in s’, e’ or a’ from any mitral site was associated with a significantly increased risk of the combined end point. However, neither the global variation nor the variation within each apical projection retained significant associations with the end point (Table). Conclusions: In the general population, systolic and diastolic TDI velocities at all mitral annular sites are important predictors of cardiac events. Along with the lack of association between intraindividual TDI variations and these events, it suggests that for the evaluation of cardiac prognosis the choice of site is of less importance.