Mitral Annular Tissue Doppler Imaging Research Articles

Atrium-driven Mitral Annulus Motion Velocity Reflects Global Left Ventricular Function and Pulmonary Congestion During Acute Biventricular Pacing

The short-term effect of acute biventricular pacing on cardiac function in patients with chronic heart failure undergoing heart surgery is widely unknown. The present study was designed to determine whether mitral annular tissue Doppler imaging (TDI) is useful to predict acute changes in global systolic function determined by the continuous cardiac output method that was measured postoperatively during various pacing configurations in patients with depressed left ventricular (LV) function. TDI peak velocities of systolic (Sm), early diastolic (Em), and late diastolic (Am) mitral annular motion waves were measured in 17 patients (age 67 +/- 8 years, 10 male) with depressed LV systolic function (LV ejection fraction < or = 35%) and QRS duration > 120 ms undergoing temporary epicardial biventricular pacing after aortocoronary bypass and valve surgery. TDI velocities, QRS duration on surface electrocardiogram, cardiac index (CI), right atrial pressure, pulmonary artery pressure, and pulmonary capillary wedge (PCW) pressure were measured simultaneously during various pacing configurations (right atrial-biventricular, right atrial-LV, right atrial-right ventricular, atrial inhibited, and no pacing). Univariate linear regression analysis showed a good correlation between Am and CI (r = 0.53, P = .0001) determined in all pacing modes, a weak correlation between Sm and CI (r = 0.31, P = .017), and no correlation between Em and CI (r = 0.21, P = .074). Am > 6 cm/s predicted a CI of 2.5 L/min/m(2) or more with a sensitivity of 95% and a specificity of 30%. All TDI values correlated negatively with PCW (r = -0.53, P = .0001 for Sm; r = -0.34, P = .01 for Em; r = -0.50, P = .0001 for Am). Am greater than 6 cm/s predicted a PCW of 16 mm Hg or less with a specificity of 100% and a sensitivity of 34%. Mean values of TDI velocities and hemodynamic parameters were not significantly different between each pacing configuration. Peak Am mitral annular velocity correlates well with CI and PCW, respectively, thus providing an easy means to assess LV systolic function and pulmonary congestion during cardiac pacing in chronic heart failure.

The Effect of Successful Electrical Cardioversion on Left Ventricular Diastolic Function in Patients with Persistent Atrial Fibrillation: A Tissue Doppler Study

Changes in mitral inflow and pulmonary venous flow after electrical cardioversion (ECV) in patients with persistent atrial fibrillation (AF) were showed in many former studies. In our study we investigated the effects of ECV on diastolic parameters by using tissue Doppler imaging (TDI) in patients with persistent AF. Forty-one (24 women) consecutive patients underwent successful elective ECV for nonvalvular persistent AF, and maintained sinus rhythm for 1 month were enrolled to the study. Transthoracic echocardiography was applied to all patients before, 24 hours after and 1 month after ECV. Mitral annular TDI parameters were also measured with mitral inflow, pulmonary venous flow, and other standard echocardiographic measurements. No differences in peak myocardial early velocity (Em), deceleration time of Em, and myocardial isovolumic relaxation time measured from mitral lateral annulus before, 24 hours after, and one month after ECV were found. Peak myocardial late velocity measured 24 hours after ECV increased significantly at the end of 1 month. There were not any changes in LV diastolic function except restoration of atrial mechanical contraction following ECV in patients with persistent AF.

Evaluation of Diastole in an Obese Young Woman: Mitral Valve Inflow Doppler vs. Mitral Annular Tissue Doppler Imaging

TDI adds to and clarifies the information on diastolic function provided by mitral valve inflow Doppler and thus is a useful echocardiographic tool for the evaluation of cardiac function, particularly in obese patients.