Clinical Application of Pulsed Doppler Tissue Imaging for Assessing Abnormal Left Ventricular Relaxation

Oki, Takashi; Tabata, Tomotsugu; Yamada, Hirotsugu; Wakatsuki, Tetsuzo; Shinohara, Hisanori; Nishikado, Akiyoshi; Iuchi, Arata; Fukuda, Nobuo; Ito, Susumu

doi:10.1016/s0002-9149(97)00015-5

Cited by 447 publications

(244 citation statements)

References 27 publications

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“…However, some studies have demonstrated that S' of not only the mitral annulus but also the other parts of the myocardial wall was correlated with LV peak +dP/dt in human patients with DCM and atrial fibrillation [22,29]. In addition, it was also reported that E' of the posterior wall negatively correlated with the LV relaxation time constant in human patients with various heart diseases [31]. Therefore, it may be important to investigate the association between LV systolic and diastolic functions and the parameters of pulsed TDI of various regions in dogs, excluding the septum of mitral annulus or myocardial walls in dogs.…”

Section: Discussionmentioning

confidence: 99%

“…Pulsed tissue Doppler imaging (pulsed TDI) derived from Doppler echocardiography can quantify the velocity of myocardial wall and/or valve annulus motions [30,31,40]. In humans, pulsed TDI of the mitral annulus and myocardial wall has been demonstrated to reflect the systolic and diastolic left ventricular (LV) function in normal subjects [30,45] and patients with dilated cardiomyopathy (DCM) [22,46], hypertrophic cardiomyopathy (HCM) [36,39,46], restrictive cardiomyopathy (RCM) [14,16,35], constrictive pericarditis [14,16,35], ischemic heart diseases [4,31,43,46], heart failure [1,24], mitral regurgitation (MR) [2,3,17], atrial fibrillation [29], arterial hypertension [13,46], and cardiac amyloidosis [20].Analysis of pulsed TDI revealed that the peak early diastolic velocity (E'), peak atrial systolic velocity (A'), and peak systolic velocity (S') are typically derived from the velocity profiles of myocardial or valve annulus motions (Fig. 1) [30].…”

mentioning

confidence: 99%

“…1) [30]. Several studies have revealed that E' and A' are correlated with LV diastolic function [1,13,16,20,24,26,31,36,39,40,45], and S' is correlated with LV systolic function [17,20,22,29,30,43,46]. E' was almost independent of preload and showed no pseudonormal pattern in contrast to the peak early diastolic velocity of LV inflow (E) [5,24].…”

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Assessment of Left Ventricular Function Using Pulsed Tissue Doppler Imaging in Healthy Dogs and Dogs with Spontaneous Mitral Regurgitation

et al. 2005

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ABSTRACT. Pulsed tissue Doppler imaging (pulsed TDI) has been demonstrated to be useful for the estimation of left ventricular (LV) systolic and diastolic functions in various human cardiac diseases. The objectives of this study were to investigate the relationship between pulsed TDI and LV function by using cardiac catheterization in healthy dogs and to evaluate the clinical usefulness of pulsed TDI in dogs with spontaneous mitral regurgitation (MR). The peak early diastolic velocity (E'), peak atrial systolic velocity (A'), and peak systolic velocity (S') were detectable in the velocity profiles of the mitral annulus in all the dogs. In the healthy dogs, S' and E' were correlated with LV peak +dP/dt and -dP/dt, respectively. E' was lower in dogs with MR than in dogs without cardiac diseases. E/E' in the MR dogs with decompensated heart failure was significantly increased in comparison with those with compensated heart failure. The sensitivity and specificity of the E/E' cutoff value of 13.0 for identifying decompensated heart failure were 80% and 83%, respectively. In addition, E/E' was significantly correlated with the ratio of left atrial to aortic diameter. These findings suggest that canine pulsed TDI can be applied clinically for estimation of cardiac function and detection of cardiac decompensation and left atrial volume overload in dogs with MR. KEY WORDS: canine, cardiac function, echocardiography, mitral regurgitation, pulsed tissue Doppler.J. Vet. Med. Sci. 67(12): 1207-1215, 2005 Doppler echocardiography is a predominant noninvasive modality that provides a large variety of useful information on cardiac conditions in human and small animal patients. Pulsed tissue Doppler imaging (pulsed TDI) derived from Doppler echocardiography can quantify the velocity of myocardial wall and/or valve annulus motions [30,31,40]. In humans, pulsed TDI of the mitral annulus and myocardial wall has been demonstrated to reflect the systolic and diastolic left ventricular (LV) function in normal subjects [30,45] and patients with dilated cardiomyopathy (DCM) [22,46], hypertrophic cardiomyopathy (HCM) [36,39,46], restrictive cardiomyopathy (RCM) [14,16,35], constrictive pericarditis [14,16,35], ischemic heart diseases [4,31,43,46], heart failure [1,24], mitral regurgitation (MR) [2,3,17], atrial fibrillation [29], arterial hypertension [13,46], and cardiac amyloidosis [20].Analysis of pulsed TDI revealed that the peak early diastolic velocity (E'), peak atrial systolic velocity (A'), and peak systolic velocity (S') are typically derived from the velocity profiles of myocardial or valve annulus motions (Fig. 1) [30]. Several studies have revealed that E' and A' are correlated with LV diastolic function [1,13,16,20,24,26,31,36,39,40,45], and S' is correlated with LV systolic function [17,20,22,29,30,43,46]. E' was almost independent of preload and showed no pseudonormal pattern in contrast to the peak early diastolic velocity of LV inflow (E) [5,24]. In addition, a ratio of E to E' (E/E') showed good correlation with pulmo...

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Assessment of Left Ventricular Function Using Pulsed Tissue Doppler Imaging in Healthy Dogs and Dogs with Spontaneous Mitral Regurgitation

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“…Therefore, we can analyze quantitatively the characteristics of myocardial wall motility throughout the cardiac cycle, which enables a more accurate analysis of myocardial performance. Several studies have been conducted to validate the method in several pathological cardiac conditions, including Chagas' disease [20][21][22][23] .…”

Section: Discussionmentioning

confidence: 99%

Doppler tissue imaging to assess systolic function in Chagas' disease

Barros¹,

Ribeiro²,

Machado³

et al. 2003

Arq. Bras. Cardiol.

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“…Thereafter, Oki et al [59] reported that the peak Ew and the time from the aortic component of the second heart sound to the peak of the Ew (IIA-Ew) of the LV wall motion velocity along the short axis are inversely and directly correlated, respectively, with the time constant of LV pressure decay during isovolumic diastole (tau) in all patients including LV compliance abnormalities (Figure 4, left). They found that the early diastolic parameters obtained using pulsed TDI facilitated the accurate evaluation of LV relaxation abnormalities without being influenced by preload.…”

Section: Diastolic Functionmentioning

confidence: 94%

The Role of Tissue Doppler Imaging as a New Diagnostic Option in Evaluating Left Ventricular Function

Oki

2003

J Echocardiogr

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In general, pump function and myocardial contractility should be assessed when evaluating left ventricular (LV) systolic function. Ejection fraction obtained from left ventriculography is routinely used as an index of pump function, and the maximum value of the first derivative of LV pressure curve (peak dP/dt) has been used as an index of myocardial contractility. On the other hand, active relaxation of the LV myocardium during early diastole and LV passive filling or compliance during mid-to late diastole are important factors in evaluating LV diastolic function. To obtain this information, the time constant of the LV pressure decay during isovolumic diastole (tau) and LV end-diastolic pressure, which are calculated from the LV pressure curve recorded during cardiac catheterization, is used. However, invasive hemodynamic measurements cannot be performed in all patients, nor are they appropriate for follow-up evaluation involving repeated examinations.Recently, routine echocardiography has facilitated the noninvasive evaluation of LV systolic and diastolic function. The percent fractional shortening of the LV based on M-mode echocardiography and the LV ejection fraction determined by two-dimensional echocardiography are indices of LV pump function, and therefore cannot accurately evaluate LV myocardial contractility. On the other hand, "diastology" has become an important clinical topic [1]. There are several reasons why assessment of diastolic function is important: 1) 30 to 40% of patients evaluated for congestive heart failure have normal LV pump function [2,3]; 2) the transmitral flow velocity pattern, which is recorded using the pulsed Doppler method, may be an index for noninvasive evaluation of LV diastolic function [4]; and 3) the prognosis is poor in patients with LV systolic dysfunction and pseudonormalization or restrictive pattern of the transmitral flow velocity [5,6]. However, it has been shown that the diastolic indices obtained from transmitral and pulmonary venous flow velocities are influenced by loading conditions, especially by the pre- The Role of Tissue Doppler Imaging as a New Diagnostic Option in Evaluating Left AbstractThe widespread use of the pulsed Doppler echocardiography has facilitated the noninvasive evaluation of hemodynamic abnormalities of the left atrium and left ventricle (LV) based on transmitral and pulmonary venous flow velocity patterns. However, it has been shown that loading conditions, especially preload, influence the indices obtained from these velocity patterns. Recently, tissue Doppler imaging (TDI) has been applied to the clinical setting to assess LV myocardial function. In particular, this procedure has the following characteristics: 1) it can provide circumferential and longitudinal information for the LV myocardium; 2) the early diastolic LV myocardial parameters determined by TDI are not influenced by preload; 3) LV myocardial contractility can be evaluated from the early systolic parameters; 4) LV systolic and diastolic asynchrony can be detected; 5) myoca...

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Clinical Application of Pulsed Doppler Tissue Imaging for Assessing Abnormal Left Ventricular Relaxation

Cited by 447 publications

References 27 publications

Assessment of Left Ventricular Function Using Pulsed Tissue Doppler Imaging in Healthy Dogs and Dogs with Spontaneous Mitral Regurgitation

Assessment of Left Ventricular Function Using Pulsed Tissue Doppler Imaging in Healthy Dogs and Dogs with Spontaneous Mitral Regurgitation

Doppler tissue imaging to assess systolic function in Chagas' disease

The Role of Tissue Doppler Imaging as a New Diagnostic Option in Evaluating Left Ventricular Function

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