ASSESSMENT OF LEFT VENTRICULAR FUNCTION USING TISSUE DOPPLER IMAGING
Abstract
Background. Objective evidence of cardiac dysfunction is one of the diagnostic criteria for heart failure. It is often hard to assess systolic function and assessing diastolic dysfunction is even harder because there are no generally accepted echocardiographic criteria. Tissue Doppler imaging (TDI) enables analysis of the mitral annular descent velocity for detection of left ventricular diastolic dysfunction along the longitudinal axis.
Methods. 30 patients with heart failure and 30 healthy participants were enrolled in the study. Pulsed wave tissue Doppler imaging velocities of septal and lateral mitral annulus borders were recorded in systole (Sm) and early diastole (Em). Velocities in both groups were compared. The correlations between Sm velocity and LVEF and Em velocity and age were studied.
Results. Patients with heart failure had significantly decreased Sm and Em velocities compared with healthy participants (5.3 ± 1.6 cm/s vs. 8.4 ± 1 cm/s, P < 0.001, for Sm velocity and 5 ± 1.4 cm/s vs. 8.7 ± 1.6 cm/s, P < 0.001, for Em velocity). The correlation between Sm velocity and LVEF in all participants was very good and highly significant (r = 0.91, P < 0.001). The Sm velocity ≥ 6.4 cm/s was 91% sensitive and 95% specific for LVEF ≥ 0.45. There was a good correlation between age and Em velocity (r = -0.84, P < 0.001). The Em velocity < 7 cm/s had a sensitivity of 90% and specificity of 97% for diagnosing heart failure.
Conclusions. Pulsed wave tissue Doppler imaging of mitral annulus enables simple, fast and precise assessment of systolic and diastolic left ventricular function. It can replace some other more time consuming echocardiographic measurements.
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References
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