Non-invasive assessment of cardiac physiology by tissue Doppler echocardiography: A comparison with invasive haemodynamics

Zamorano, José Luís; Wallbridge, David; Ge, Jianli; Drozd, Jakub; Nesser, Joachim; Erbel, Raimund

doi:10.1093/oxfordjournals.eurheartj.a015236

Cited by 95 publications

(48 citation statements)

References 23 publications

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“…The increase in Sw1 along the long axis contributes to spherical changes in the LV cavity during isovolumic contraction phase [23], and therefore a decrease in this peak velocity can be useful in the early diagnosis of impaired contractility in elderly individuals with normal LV pump function [24,25]. With respect to the TDI findings during early systole, Zamorano et al [26] simultaneously recorded M-mode color TDI and LV-aortic-left atrial pressures, and reported that there was a good correlation between the time interval assessed hemodynamically and that based on the velocity interface obtained with M-mode color TDI during the isovolumic contraction phase. Another study reported that there is a positive correlation between the preejectional peak velocity and LV ejection fraction in normal individuals [27].…”

Section: Systolic Functionmentioning

confidence: 99%

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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Section: Systolic Functionmentioning

confidence: 99%

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

Oki

2003

J Echocardiogr

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“…These phases were defined using the combined information derived from M-mode images taken at the tips of mitral valve leaflets with visible valve openings and the simultaneously recorded ECG and phonocardiogram. 17,20,28 To obtain M-mode DMI images, the echocardiographic examination was extended by 2 to 3 minutes. Another 5 to 10 minutes were used for off-line analysis of images.…”

Section: Doppler Myocardial Imagingmentioning

confidence: 99%

Differentiation Between Restrictive Cardiomyopathy and Constrictive Pericarditis by Early Diastolic Doppler Myocardial Velocity Gradient at the Posterior Wall

et al. 2000

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Background-The differential diagnosis between restrictive cardiomyopathy (RCM) and constrictive pericarditis (CP) is challenging and, despite combined information from different diagnostic tests, surgical exploration is often necessary. Methods and Results-A group of 55 subjects (mean age, 63Ϯ11 years; 36 men and 19 women) were enrolled in the study; 15 had RCM, 10 had CP, and 30 were age-matched, normal controls. The diagnosis of RCM was supported by a biopsy; in the CP group, the diagnosis was confirmed either surgically or at autopsy. All patients underwent a transthoracic echocardiogram that included the assessment of Doppler myocardial velocity gradient (MVG), as measured from the left ventricular posterior wall during the predetermined phases of the cardiac cycle. MVG was lower (PϽ0.01) in RCM patients compared with both CP patients and normal controls during ventricular ejection (2.8Ϯ1.2 versus 4.4Ϯ1.0 and 4.7Ϯ0.8 s Ϫ1 , respectively) and rapid ventricular filling (1.9Ϯ0.8 versus 8.7Ϯ1.7 and 3.7Ϯ1.4 s Ϫ1 , respectively). Additionally, during isovolumic relaxation, MVG was positive in RCM patients and negative in both CP patients and normal controls (0.7Ϯ0.4 versus Ϫ1.0Ϯ0.6 and Ϫ0.4Ϯ0.3 s Ϫ1 , respectively; PϽ0.01). During atrial contraction, MVG was similarly low (PϽ0.01) in both RCM and CP patients compared with normal controls (1.6Ϯ1.7 and 1.7Ϯ1.8 versus 3.8Ϯ0.9 s Ϫ1 , respectively). Conclusions-Doppler

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“…The potential of identifying subendocardial impairment due to nontransmural ischaemia that is not detectable by twodimensional echocardiography could add important information during provocative tests. It has also been noted that several changes in myocardial layer velocities derived from Doppler tissue imaging could represent a mean for the non-invasive assessment of vessel patency early after the onset of acute myocardial infarction [46,47] . If successful, the non-invasive prediction of vessel patency after thrombolytic therapy, based on serial assessment of regional systolic and diastolic myocardial velocities, could impact on the need for early invasive testing and rescue angioplasty in patients treated with thrombolytics during acute myocardial infarction.…”

Section: Future Clinical Applications In Myocardial Ischaemiamentioning

confidence: 99%

Quantitative systolic and diastolic transmyocardial velocity gradients assessed by M-mode colour Doppler tissue imaging as reliable indicators of regional left ventricular function after acute myocardial infarction

Garot

Dérumeaux²,

Monin³

et al. 1999

European Heart Journal

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AimsThe aim of this study was to determine whether myocardial velocity gradients assessed by M-mode colour Doppler tissue imaging could be of clinical relevance and represent reliable indicators of regional left ventricular function after acute myocardial infarction. Methods and ResultsAmong 64 consecutive patients with a first acute myocardial infarction, in 50 who had a marked asynergy in the parasternal short-axis view at the mid-papillary muscle level, myocardial velocities and velocity gradients were assessed in the anteroseptum and posterior wall by M-mode Doppler tissue imaging. Similar measurements were obtained in 11 matched healthy volunteers who served as a control group.In patients with anterior myocardial infarction, the peak myocardial velocity gradient in the anteroseptum was significantly lower when compared with controls (mean [SD] 0·0 0·5 vs 1·1 0·7 s 1 during systole, P<0·01; and 0·3 0·6 vs 2·0 0·5 s 1 during diastole, P<0·01). Conversely, the peak systolic myocardial velocity gradient in the posterior wall was significantly higher than in controls (2·6 1·2 vs 1·8 1·2 s 1 , P<0·05).In patients with inferior myocardial infarction, the peak velocity gradient in the posterior wall was significantly lower when compared with healthy subjects (0·9 0·6 vs 1·8 1·2 s 1 during systole and 1·4 1·4 vs 4·9 1·2 s 1 during diastole, both P<0·01). The peak systolic tissue velocity gradient in the anteroseptum was significantly higher than in controls (2·1 1·0 vs 1·1 0·7 s

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Non-invasive assessment of cardiac physiology by tissue Doppler echocardiography: A comparison with invasive haemodynamics

Cited by 95 publications

References 23 publications

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

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

Differentiation Between Restrictive Cardiomyopathy and Constrictive Pericarditis by Early Diastolic Doppler Myocardial Velocity Gradient at the Posterior Wall

Quantitative systolic and diastolic transmyocardial velocity gradients assessed by M-mode colour Doppler tissue imaging as reliable indicators of regional left ventricular function after acute myocardial infarction

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