Tissue Doppler Imaging For Assessment Research Articles

The prognostic value of tissue Doppler imaging in assessment of left ventricular function in patients with non-ST segment elevation myocardial infarction (NSTEMI) after successful revascularization

The prognostic value of tissue Doppler imaging in assessment of left ventricular function in patients with non-ST segment elevation myocardial infarction (NSTEMI) after successful revascularization

Novel biomarkers for subtle myocardial involvement in type I diabetes mellitus.

BackgroundEvaluation of certain biomarkers could be used to predict left ventricular (LV) and right ventricular (RV) function impairment in children with type 1 diabetes mellitus. The aim of this study was to determine the best cardiac biomarker for prediction of diabetic cardiomyopathy.MethodologyThis study was designed as case-control study. A total of 55 children with type 1 diabetes mellitus (group/G1) and 55 healthy controls (G2) were subjected to echocardiography including 3D-Speckle Tracking Echocardiography and tissue Doppler imaging for assessment of RV and LV systolic and diastolic functions. As well as HbA1c, troponin I, brain natriuretic peptide (BNP), plasma cardiotrophin (CT-1), activin-A, transforming growth factor-β, and human insulin-like growth factor binding protein-7 (IGFBP-7) measurements.ResultsDiabetic patients showed RV and LV systo-diastolic dysfunction compared to controls, the best predictor of LV systolic dysfunction was CT-1 (sensitivity: 69%, while IGFBP-7 was found to be the best predictor of RV systolic dysfunction (sensitivity: 63%). BNP was found to the best predictor of diastolic RV and LV dysfunction (sensitivity: 82% for both).ConclusionCT-1 has proven to be a diagnostic superiority in LV systolic dysfunction whilst BNP continues to prove every day through our study and through many others that it is the chief marker of diastolic dysfunction and HFpEF. This potential accuracy and the increasing availability of BNP in the outpatient setting make it clear that it should be used as a screening test for diabetic patients.

P5227Value of tissue Doppler imaging in assessment of right ventricular function in patients with chronic renal failure on regular hemodialysis

P5227Value of tissue Doppler imaging in assessment of right ventricular function in patients with chronic renal failure on regular hemodialysis

Role of Echocardiographic Tissue Doppler Imaging in Assessment of Myocardial Diastolic Dysfunction in Children with Diffuse Lung Diseases

Role of Echocardiographic Tissue Doppler Imaging in Assessment of Myocardial Diastolic Dysfunction in Children with Diffuse Lung Diseases

Conventional Echocardiography and Tissue Doppler Imaging in Assessment of Left Ventricular Function in Obese Asymptomatic Children

Conventional Echocardiography and Tissue Doppler Imaging in Assessment of Left Ventricular Function in Obese Asymptomatic Children

Usefulness of Pulsed Wave Tissue Doppler Imaging in Assessment of Left Ventricular Functions in Children with Beta-Thalassemia Major

To evaluate the changes in the LV systolic and diastolic function in children with beta-thalassemia major (β-TM) using pulsed wave tissue doppler (TD) echocardiography. Clinical, conventional echo doppler and pulsed wave tissue doppler imaging parameters were compared in 40 beta-thalassemia major patients (mean age, 6.52 ± 3.5 y) and 25 age and sex matched normal subjects (mean age, 6.5 ± 2.7 y). There were no significant statistical differences between mean fractional shortening (FS) and ejection fraction (EF) of left ventricle (LV) of the patients and control group. Children with beta-thalassemia had significantly lower E' wave velocities measured at the left ventricular septal annulus (8.1 ± 3.3 vs. 13 ± 2.5, P < 0.001), lateral margin of the mitral annulus (9.1 ± 5.4 vs. 13.3 ± 2.5, P < 0.001) and lateral margin of the tricuspid annulus (9.3 ± 3.9 vs. 13.3 ± 2.5, P < 0.001) when compared to the control group. Furthermore children with beta-thalassemia had significantly lower E'/A' wave ratio at the left ventricular septal annulus (0.76 ± 0.34 vs. 1.36 ± 0.23), lateral margin of the mitral annulus (0.83 ± 0.17 vs. 1.28 ± 0.22), and lateral margin of the tricuspid annulus ((0.90 ± 0.27 vs. 1.26 ± 0.23, (P < 0.05) when compared to the control group. This study showed that patients with beta-thalassemia major and normal conventional echo doppler parameters had statistically significant changes detected by pulsed wave tissue doppler imaging.

Myocardial dysfunction in neonatal sepsis

To assess myocardial performance in septic full-term infants and to correlate it with serum cardiac troponin T concentrations. Prospective, case-control, clinical study. Neonatal intensive care unit in a university hospital. Twenty septic and 20 nonseptic full-term neonates. None. Conventional echocardiography, tissue Doppler imaging, and serum cardiac troponin T concentration tests were performed as soon as diagnosis was made. On tissue Doppler imaging measurements, right ventricular and left ventricular Tei indexes were significantly higher in septic neonates compared to nonseptic neonates (mean ± SD: 0.51 ± 0.09 vs. 0.28 ± 0.05, p < .001, and 0.56 ± 0.07 vs. 0.39 ± 0.04, p < .001, respectively). Mitral and tricuspid peak annular systolic velocities were significantly lower in septic neonates (mean ± SD: 4.35 ± 0.68 vs. 6.89 ± 0.94 cm/sec, p < .0001, and 5.55 ± 0.66 vs. 6.69 ± 0.87 cm/second, p < .0001, respectively). On conventional echocardiography measurements, left ventricular internal diameter at end-diastole was significantly higher in septic neonates (p = .04), whereas cardiac index and left ventricular and right ventricular diastolic functions were not significantly different between septic and nonseptic neonates. Cardiac troponin T concentrations were significantly higher in septic neonates (median [range], 0.19 [0.12- 0.32] vs. 0.03 [0-0.07] mg/L, p < .0001), and they correlated positively with left ventricular Tei index (r = .80; p < .0001) and right ventricular Tei index (r = .73; p < .0001), and correlated negatively with mitral peak annular systolic velocity (r = -.70; p < .0001) and tricuspid peak annular systolic (r = -.39, p = .012). Nonsurvivors had significantly higher serum cardiac troponin T concentrations and left ventricular Tei index. Neonatal sepsis is associated with systolic and diastolic myocardial dysfunction. This study provides proof-of-concept data for the use of tissue Doppler imaging in assessment of myocardial dysfunction in septic neonates. Tissue Doppler imaging appears to be more sensitive than conventional echocardiography in the detection of this dysfunction. Serum cardiac troponin T and left ventricular Tei index may have prognostic value in these patients.

Cardiomyopathies: Classification, Clinical Characterization, and Functional Phenotypes

Cardiomyopathies: Classification, Clinical Characterization, and Functional Phenotypes

Comparison of two-dimensional strain and tissue Doppler imaging based right ventricular longitudinal systolic function in normal subjects and patients with pulmonary arterial hypertension

Objective To assess right ventricular systolic function in normal subjects and patients with pulmonary arterial hypertension (PAH) by using 2-dimensional strain (2DS) and tissue Doppler imaging(TDI), and to investigate the feasibility of 2DS for quantitative assessment of myocardial longitudinal systolic function. Methods Longitudinal peak systolic velocity (V), peak systolic strain(e), peak systolic strain rate(SRS) were measured in right ventricular free wall for basal,mid and apical segment in 42 patients with PAH and 31 healthy controls by 2DS and TDI from the apical 4-chamber view and compared between 2DS and TDI. Results ①Compared with controls,e and SRS of the mid segment of the right ventricular free wall by TDI were significantly reduced in patients with PAH (P 0.05). e and SRS of all segments by 2DS were markedly reduced in patients with PAH (all P 0.05). ②In normal subjects,values(V,e,SRS) of basal and apical segment of right ventricular free wall measured by 2DS were significantly different from those by TDI (P 0.05); In patients with PAH, values (V, e, SRS) of apical segment of right ventricular free wall by 2DS were significantly different from those by TDI,values of basal and mid segment by 2DS and TDI were not significantly different. ③ There were good correlations between 2DS and TDI in patients with PAH (r = 0.406～0.760, P<0.05 for all). Conclusions Right ventricular longitudinal systolic function in patients with PAH was decreased, 2DS is more accurate and objective than TDI in assessment of right ventricular longitudinal systolic function. Key words: Echocardiography; Ventricular function, right; Two-dimensional strain imaging; Hypertension, pulmonary

Methods and Reliability of Tissue Doppler Imaging for Assessment of Left Ventricular Radial Wall Motion in Horses

Noninvasive assessment of left ventricular (LV) function is incompletely studied in horses. The goals of this study were to investigate the feasibility, techniques, and reliability of tissue Doppler imaging (TDI) for characterization of LV radial wall motion in healthy horses. Three Standardbreds, 3 Thoroughbreds; age 8-14 years; body weight 517-606 kg. Repeated echocardiographic examinations were performed by 2 observers in unsedated horses using TDI. Test reliability was determined by estimating measurement variability, within-day interobserver variability, and between-day interobserver and intraobserver variability of all echocardiographic variables. Variability was expressed as coefficient of variation (CV) and the absolute value below which the difference between 2 measurements will lie with 95% probability. Assessment of LV radial wall motion by TDI was feasible in all horses. Measurement variabilities were very low (CV < 5%) to low (CV 5-15%) for most variables. Within-day interobserver variability as well as between-day interobserver and intraobserver variabilities were low to moderate (CV 16-25%) for most variables. All pulsed-wave TDI variables of systolic LV function showed very low to low variability, whereas some of the variables of LV diastolic and LA function showed moderate to high (CV > 25%) variability. Pulsed-wave TDI variables appeared more reliable than color TDI variables. Measurement of TDI indices of LV function is feasible and reliable in adult Standardbred and Thoroughbred horses. The clinical relevance of LV function assessment by TDI remains to be determined.

Abstract 2713: Comparison of MRI Myocardial Tissue Tagging and Tissue Doppler Imaging for Assessment of Mechanical Dyssynchrony

Background: Echocardiographic (EC) indices of mechanical dyssynchrony (MD) are based largely upon longitudinal strain, whereas magnetic resonance imaging myocardial tissue tagging (MRI-MT) assessment is based on circumferential strain, the latter being the primary direction of myocardial contraction. Methods: We sought to compare cardiac MRI studies with an EC protocol using 2D imaging, tissue Doppler imaging (TDI), and M-mode in 32 subjects. Absolute strain, time to peak strain in 6 segments, TDI septal-to-lateral delay (SLD; MD if ≥ 70 ms), and M-mode septal-to-posterior wall motion delay (SPWMD; MD if ≥ 130 ms) were measured and compared to the MRI-MT-based CURE (circumferential uniformity ratio estimate, CURE; 0 –1, 0 = asynchrony, 1 = perfect synchrony; MD if &lt; 0.75), which recently has been shown to predict clinical CRT response. Results: The 8 control subjects (normal QRSd; CURE 0.975 ± 0.01; SLD 26 ± 27 ms) had less MD by MRI-MT (p = 0.0001) and TDI (p = 0.04) as compared to 24 subjects with ejection fraction ≤ 35% (QRSd 135 ≤ 35 ms; CURE 0.695 ± 0.17; SLD 59 ± 39 ms). There was a moderate correlation between TDI and MRI-MT (R = 0.62), with a discordance rate of 22% overall and 25% in cardiomyopathy subjects, in some cases due to abnormal CURE with normal SLD and, in others, normal CURE with abnormal SLD. The M-mode assay (SPWMD) could not be assessed in 10 patients with septal akinesis (AK), although there was MD by TDI and MRI-MT in most of these subjects. In the patients without AK, the discordance rate between TDI and M-mode was 33%. Conclusions: MRI-MT assessment of circumferential strain and MD is complementary to TDI with a good correlation, but also a significant discordance rate.

Predictive Accuracy of Tissue Doppler Imaging for Assessment of Noninfarct Myocardial Region in Patients with Acute Myocardial Infarction

Objectives: To investigate the value of pulsed tissue Doppler imaging (TDI) in order to predict significant coronary artery stenosis supplying the noninfarct region in patients after acute anterior myocardial infarction. Subjects and Methods: Transthoracic echocardiography and coronary angiography were performed on 220 patients with acute anterior myocardial infarction. The TDI-derived variables of the mitral valve annulus in the noninfarct region, systolic velocity (Sm), early diastolic velocity (Em) and late diastolic velocity (Am), were estimated in centimeters per second, and the Em/Am ratio was calculated. Results: Predictive indices revealed that the impaired TDI-derived variables, Sm, Em, Am and the Em/Am ratio, were an indicator for predicting significant coronary stenosis in the noninfarct region. Multivariate analysis revealed that the impaired Sm and Em velocities were significantly associated with age of the patients, coronary collaterals and infarct-related artery stenosis (p < 0.05). Receiver-operating characteristic curve data of TDI-derived variables for prediction of significant coronary stenosis revealed that the cut-off values of Sm, Em, Am and Em/Am ratio were 7.2 cm/s, 6.4 cm/s, 12.1 cm/s and 0.56, respectively. The ĸ coefficient value indicated that there was an agreement between coronary angiography and the TDI-derived variables Sm, Em, Am and Em/Am ratio in noninfarct regions (ĸ = 0.770, 0.731, 0.693 and 0.679, respectively). There was a significant correlation between the severity of coronary artery stenosis (independent variable) and impaired Sm and Em/Am ratio (dependent variables), y = 11.5 – 0.05x, r = –0.902, (p < 0.05), and y = – 0.14x + 1.87, r = –0.754, (p < 0.05), respectively. Conclusion: TDI can be used to identify patients with significant stenosis of the coronary arteries supplying the noninfarct region and consequently may be helpful in considering patients for coronary angiography in the early postinfarction period.

1028: Tissue Doppler imaging for assessment of ventricular function

Ideal assessment of ventricular segmental function consists of amplitude, velocity and timing. While amplitude can easily be measured by M-mode echocardiography, velocities can be easily quantified by tissue Doppler imaging (TDI). It is of great importance to study tissue Doppler in the context of overall segmental function, rather than in isolation, particularly in patients with heart failure in whom the pattern might be significantly confusing. Normal values of tissue Doppler myocardial velocities have been identified not only in adults but in children and in foetuses.

Use of quantitative two-dimensional color tissue Doppler imaging for assessment of left ventricular radial and longitudinal myocardial velocities in dogs

To determine left ventricular free wall (LVFW) radial and longitudinal myocardial contraction velocities in healthy dogs via quantitative 2-dimensional color tissue Doppler imaging (TDI). 100 dogs. TDI was used by a single trained observer to measure radial and longitudinal myocardial movement in the LVFW. Radial myocardial velocities were recorded in segments in the endocardial and epicardial layers of the LVFW, and longitudinal velocities were recorded in segments at 3 levels (basal, middle, apical) of the LVFW. LVFW velocities were higher in the endocardial layers than in the epicardial layers. Left ventricular free wall velocities were higher in the basal segments than in the middle and apical segments. Radial myocardial velocity gradients, defined as the difference between endocardial and epicardial velocities, were (mean +/- SD) 2.5 +/- 0.8 cm/s, 3.8 +/- 1.5 cm/s, and 2.3 +/- 0.9 cm/s in systole, early diastole, and late diastole, respectively. Longitudinal myocardial velocity gradients, defined as the difference between basal and apical velocities, were 5.9 +/- 2.2 cm/s, 6.9 +/- 2.5 cm/s, and 4.9 +/- 1.7 cm/s in systole, early diastole, and late diastole, respectively. A breed effect was detected for several systolic and diastolic TDI variables. In all segments, systolic velocities were independent of fractional shortening. LVFW myocardial velocities decreased from the endocardium to the epicardium and from base to apex, thus revealing intramyocardial radial and longitudinal velocity gradients. These indices could enhance conventional echocardiographic analysis of left ventricular function in dogs. Breed-specific reference intervals should be defined.