Tissue Doppler Imaging For Detection Research Articles

Equilibrium radionuclide angiography compared with tissue doppler imaging for detection of right ventricular dyssynchrony and prediction of acute response to cardiac resynchronization therapy.

Objective:The aim of this study was to compare tissue doppler imaging (TDI) and equilibrium radionuclide angiography (ERNA) for detection of right ventricular (RV) dyssynchrony and prediction of the acute response to cardiac resynchronization therapy (CRT).Methods:This study was approved by the local ethics committee of Huai’an First People's Hospital. Patient consent was not provided due to the use of completely anonymous images from which the individual could not be identified in this study. Thirty-three patients with nonischemic dilated cardiomyopathy underwent both TDI and ERNA before and within 48 hour after CRT implantation. RV dyssynchrony was measured with TDI using the difference in time to peak systolic velocity between the RV free wall and ventricular septum (RV-T). With ERNA, the standard of RV mean phase angle and RV phase standard deviation (RVmPA% and RVPSD%) were assessed.Results:Moderate positive correlations were observed among baseline RVmPA%, RVPSD% and RV-T (r = 0.689 and 0.716, P < .001). Twenty patients (61%) with a reduction of at least 15% in LV end-systolic volume were categorized as acute responders after CRT. Responders showed significant reduction in RVmPA% and RVPSD% after CRT (53.60 ± 4.15% to 43.95 ± 6.88% and 14.00 ± 2.41% to 10.40 ± 1.67%, P < .05), whereas RV-T remained unchanged (50.10 ± 10.28 ms to 49.25 ± 13.64ms, NS). Receiver operating characteristic curve showed that the cut-off value of RV-T was 48.5ms, yielding 65% sensitivity and 77% specificity to predict acute respond to CRT. The cut-off value of RVmPA% was 49.5%, yielding 85% sensitivity and 85% specificity and the cut-off value of RVPSD% was 11.5%, yielding 85% sensitivity and 92% specificity.Conclusion:ERNA might be an appropriate alternative to TDI for assessment of RV dyssynchrony. Either RVmPA% or RVPSD% was highly predictive for acute response to CRT.

Growth-differentiation Factor-15 and Tissue Doppler Imaging in Detection of Anthracycline-induced Cardiomyopathy During Therapy of Childhood Cancers.

The aim of this study was to evaluate the importance of growth-differentiation factor-15 (GDF-15) levels and tissue Doppler imaging (TDI) in the early detection of anthracycline-induced cardiomyopathy during the treatment of childhood cancers. Twenty patients (13 males and 7 females) newly diagnosed with childhood cancer whose treatment protocol included anthracycline were included in the study. Echocardiography, including M-mode, pulse Doppler, and TDI, was performed after the first anthracycline treatment at cumulative doses of 100, 200, and 300 mg/m and at least 6 months after the last treatment. GDF-15 and troponin-I were also measured at these time points. The median age of the patients was 14 years (range, 3 to 18 y). The median cumulative anthracycline dose was 220 mg/m (range, 60 to 400 mg/m). Conventional pulse wave and pulse wave tissue Doppler methods revealed significant differences in the right ventricular myocardial performance indices of the patients who received cumulative anthracycline doses of 300 mg/m compared with their indices at least 6 months after the last treatment. The serum GDF-15 levels after the cumulative anthracycline dose of 200 mg/m were also higher than the patients' pretreatment levels. Doppler/TDI and GDF-15 levels may be used in the early determination of anthracycline-induced cardiomyopathy during the treatment of childhood cancers.

Role of Tissue Doppler Imaging for Detection of Diastolic Dysfunction in the Elderly

The role of tissue Doppler imaging (TDI) in the assessment of diastolic dysfunction in elderly patients seen in echocardiographic practice is poorly defined.The aim of this study was to investigate the prevalence of diastolic dysfunction in a cohort of elderly patients referred to an echocardiographic examination for routine clinical indications and to compare the findings obtained by conventional Doppler with those obtained by TDI.A total of 457 elderly patients with preserved left ventricular (LV) systolic function (mean age 73 ± 5 years, 45% men, 76% with hypertension) underwent a comprehensive echo-Doppler examination; diastolic dysfunction was defined by the following conventional and TDI criteria: E/A ratio (ratio between transmitral peak velocity of E and A waves) <0.7 or >1.5 and lateral annular early diastolic peak velocity (Ei) <8 cm/sec, respectively.Diastolic dysfunction was present in 130 patients (28.4%) according to the conventional Doppler criterion, namely 119 (26.0%) because of E/A <0.7 and 11 because of E/A >1.5. A higher proportion of participants (60.1%) had LV diastolic dysfunction according to TDI. Notably, more than one-half of the patients with 'normal' diastolic function by conventional criterion exhibited an abnormal Ei value.A large proportion of elderly patients with normal E/A ratios may have more subtle alterations in LV diastolic mechanics characterized by a reduced annular motion velocity. Thus, evaluation of diastolic function by the simple E/A ratio may markedly underestimate diastolic abnormalities. This finding supports the view that diastolic function should be routinely assessed by comprehensive Doppler methodologies including both conventional and tissue Doppler measurements in order to improve the management of elderly patients seen in clinical practice.

Tissue Doppler Imaging for Detection of Radial and Longitudinal Myocardial Dysfunction in a Family of Cats Affected by Dystrophin‐Deficient Hypertrophic Muscular Dystrophy

Diagnosis of feline hypertrophic cardiomyopathy currently is based on the presence of myocardial hypertrophy detected using conventional echocardiography. The accuracy of tissue Doppler imaging (TDI) for earlier detection of the disease has never been described. The objective of this sudy was to quantify left ventricular free wall (LVFW) velocities in cats with hypertrophic muscular dystrophy (HFMD) during preclinical cardiomyopathy using TDI. The study animals included 22 healthy controls and 7 cats belonging to a family of cats with HFMD (2 affected adult males, 2 heterozygous adult females, one 2.5‐month‐old affected male kitten, and 2 phenotypically normal female kittens from the same litter). All cats were examined via conventional echocardiography and 2‐dimensional color TDI. No LVFW hypertrophy was detected in the 2 carriers or in the affected kitten when using conventional echocardiography and histologic examination, respectively. The LVFW also was normal for 1 affected male and at the upper limit of normal for the 2nd male. Conversely, LVFW dysfunction was detected in all affected and carrier cats with HFMD when using TDI. TDI consistently detects LVFW dysfunction in cats with HFMD despite the absence of myocardial hypertrophy. Therefore, TDI appears more sensitive than conventional echocardiography in detecting regional myocardial abnormalities.

Tissue Doppler Imaging for Detection of Radial and Longitudinal Myocardial Dysfunction in a Family of Cats Affected by Dystrophin-Deficient Hypertrophic Muscular Dystrophy

Diagnosis of feline hypertrophic cardiomyopathy currently is based on the presence of myocardial hypertrophy detected using conventional echocardiography. The accuracy of tissue Doppler imaging (TDI) for earlier detection of the disease has never been described. The objective of this sudy was to quantify left ventricular free wall (LVFW) velocities in cats with hypertrophic muscular dystrophy (HFMD) during preclinical cardiomyopathy using TDI. The study animals included 22 healthy controls and 7 cats belonging to a family of cats with HFMD (2 affected adult males, 2 heterozygous adult females, one 2.5-month-old affected male kitten, and 2 phenotypically normal female kittens from the same litter). All cats were examined via conventional echocardiography and 2-dimensional color TDI. No LVFW hypertrophy was detected in the 2 carriers or in the affected kitten when using conventional echocardiography and histologic examination, respectively. The LVFW also was normal for 1 affected male and at the upper limit of normal for the 2nd male. Conversely, LVFW dysfunction was detected in all affected and carrier cats with HFMD when using TDI. TDI consistently detects LVFW dysfunction in cats with HFMD despite the absence of myocardial hypertrophy. Therefore, TDI appears more sensitive than conventional echocardiography in detecting regional myocardial abnormalities.

Comparison of left ventricular function by tissue Doppler imaging in patients with diabetes mellitus without systemic hypertension versus diabetes mellitus with systemic hypertension

Because diabetes mellitus substantially increases the risk of development of heart failure, we sought to establish early alterations in left ventricular systolic and diastolic function in patients with diabetes mellitus with and without coexisting systemic hypertension. We studied 134 subjects using echocardiography comprising standard 2-dimensional and conventional Doppler as well as tissue Doppler imaging. Our study demonstrated the early appearance of both left ventricular systolic and diastolic dysfunction in diabetic patients at rest and the contributory effects of diabetes to myocardial impairment produced by hypertension, as well as the high usefulness of tissue Doppler imaging in detection and quantitation of myocardial dysfunction in diabetics. This method was superior to other echocardiographic techniques and plasma brain natriuretic peptide evaluation.

Transesophageal Dobutamine Stress Echocardiography With Tissue Doppler Imaging for Detection and Assessment of Coronary Artery Disease

BackgroundTransesophageal dobutamine stress echocardiography (T-DSE) has been shown to be a sensitive and specific technique for the detection of myocardial ischemia. A major limitation of echocardiographic study interpretation, however, is...

Tissue Doppler imaging in detection of myocardial dysfunction in survivors of childhood cancer treated with anthracyclines

The applicability of tissue Doppler imaging (TDI) was investigated for estimating cardiac function in long-term survivors of childhood cancer treated with anthracyclines. A total of 63 children (age range 7.8–17.3 y) underwent standard echo Doppler cardiographic studies of blood flow velocities, left ventricular dimensions and fractional shortening, followed by measurements of peak myocardial velocities and direction using the noninvasive tissue Doppler imaging (TDI) technique. All 63 were late survivors (median 7.1 y, range 3.5–13.5 y after end of therapy) who had received mean (± SD) cumulative dose of 242 (± 141) mg/m 2 of anthracyclines. The control group consisted of 160 healthy subjects (age range 4 to 17.9 y). Standard echo-Doppler anatomical parameters that were found significantly ( p < 0.01) different for the study group are: RV wall thickness (decreased); LV diameter (increased); and LV fractional shortening (decreased). Studied hemodynamic parameters were not found to be different between the two groups. Quantitative TDI parameters: peak late diastolic myocardial velocities, as well as transmyocardial systolic and diastolic velocity differences, were significantly lower in late survivors than in the healthy pediatric population ( p < 0.01). Qualitative local functional impairment of the movement of the left ventricular walls was detected in 20% of the patients. TDI might become a useful noninvasive method for detecting subclinical myocardial damage in apparently healthy children who received moderate doses of anthracyclines for treatment of childhood malignancy. Prospective studies with TDI for the detection of regional myocardial abnormalities are recommended.

Transesophageal dobutamine stress echocardiography with tissue doppler imaging for detection and assessment of coronary artery disease

Transesophageal dobutamine stress echocardiography with tissue doppler imaging for detection and assessment of coronary artery disease