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

Abstract

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...

The Effect of Furosemide on Left Atrial Pressure in Dogs with Mitral Valve Regurgitation

“…Many reports have shown that E/Ea is a good index for the estimation of LAP and left ventricular filling pressure. [12][13][14][26][27][28] In the present study, E wave and E/Ea were significantly decreased after the administration of furosemide (Figs 6 and 7). This result suggests that E wave and E/Ea can be used for the evaluation of furosemide treatment at a high dosage, and monitoring of the reduction of LAP in the short term.…”

“…[12][13][14] Few studies have evaluated the LAP after the administration of furosemide with comparison between IV and PO routes. In the present study, our findings indicate that LAP is significantly lowered by furosemide in experimental cases, and the 2 administration routes have almost the same pharmacological actions in LAP-lowering effect.…”

Assessment and Quantification of Acquired Valvular Regurgitation in Dogs

“…It is usually thinner, elongated, and often prolapsed (Figure 11-25). Second, the LV systolic dysfunction seems to be more pronounced in larger breeds than in small dogs, with a marked increase of the ESVI [19,55]. Atrial fibrillation is often observed [55].…”

“…The proposed threshold values for identification of elevated LAP (>20 mm Hg) in dogs with DMVD are E >1.25 m/s, E/E′ >12, IVRT <45 ms, and E/IVRT >2.5 [22,55].…”

Echocardiographic evaluation including tissue Doppler imaging in New Zealand white rabbits sedated with ketamine and midazolam

“…Parameters obtained with tissue Doppler imaging (TDI) have been shown to be more independent of pre-and after-load than classic haemodynamic Doppler measurements and can be used to quantify regional myocardial function accurately and more objectively (Sohn et al, 1997;Firstenberg et al, 2001;Nagueh et al, 2001). Pulsed TDI of the mitral annulus and myocardial wall has been suggested as a means to assess systolic and diastolic left ventricular (LV) function in human and veterinary medicine (Oki et al, 1999;Chetboul et al, 2005;Teshima et al, 2005;Chetboul et al, 2006;O'Sullivan et al, 2007). The Tei index, a new parameter to assess myocardial performance, has been proposed for the assessment of global cardiac performance (systolic and diastolic function) in a wide variety of congenital and acquired cardiac abnormalities (Dujardin et al, 1998;Bruch et al, 2002;Haque et al, 2002;Harjai et al, 2002;Gaibazzi et al, 2005;Dyer et al, 2006).…”