Color-coded measures of myocardial velocity throughout the cardiac cycle by tissue Doppler imaging to quantify regional left ventricular function

Gorcsan, John; Gulati, Vijay K.; Mandarino, William A.; Katz, William E.

doi:10.1016/s0002-8703(96)90097-6

Cited by 210 publications

(112 citation statements)

References 22 publications

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“…patients with coronary artery disease, myocardial ischemia is characterized by a decrease in peak systolic myocardial velocity, indicating impairment of regional contractile function. 3,9,10 The present study, however, demonstrates important limitations in the ability of peak systolic velocity to serve as a quantitative marker of regional function. Furthermore, we demonstrate how a more comprehensive analysis of the myocardial Doppler velocity signal may improve the ability of TDI to identify ischemic myocardium.…”

Section: Discussionmentioning

confidence: 70%

“…Tissue Doppler imaging (TDI) has been introduced as a method to quantify myocardial function in terms of tissue velocities, and the results so far are promising. [1][2][3][4][5][6][7] Ischemic regions are characterized by a decrease in systolic velocities at rest or during stress echocardiography. 8 -10 The clinical implementation of TDI, however, has been relatively slow, and most echocardiographic laboratories do not apply TDI as a routine diagnostic method.…”

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confidence: 99%

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Quantification of Left Ventricular Systolic Function by Tissue Doppler Echocardiography

Edvardsen¹,

Urheim²,

Skulstad³

et al. 2002

Circulation

182

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Background-Tissue Doppler imaging (TDI) is a potentially powerful method for diagnosing myocardial ischemia. This study was designed to investigate how velocity patterns in ischemic myocardium relates to regional function, and to determine whether timing of velocity measurements relative to ejection and isovolumic phases may increase the diagnostic power of TDI. 05). When velocities during isovolumic contraction (IVC) and isovolumic relaxation (IVR)were included, TDI correlated well with sonomicrometry; ie, systolic lengthening occurred predominantly during IVC and was evident as negative velocities (rϭ0.70, PϽ0.001), and postsystolic shortening during IVR (rϭ0.72, PϽ0.001) as positive velocities. In nonischemic myocardium peak systolic strain rates were more uniform than velocities. Conclusion-The present results indicate that peak ejection velocity is an inappropriate measure of function in severely ischemic myocardium. Dyskinetic myocardium deforms predominantly during the isovolumic phases, and therefore IVC and IVR velocities are better markers of function. When isovolumic as well as ejection velocities are measured, TDI has excellent ability to quantify regional myocardial dysfunction. Longitudinal strain rates are more uniform than velocities and may further improve the diagnostic power of TDI.

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Section: Discussionmentioning

confidence: 70%

mentioning

confidence: 99%

Quantification of Left Ventricular Systolic Function by Tissue Doppler Echocardiography

Edvardsen¹,

Urheim²,

Skulstad³

et al. 2002

Circulation

182

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“…It has been demonstrated that myocardial motion velocity, determined by pulsed TDI [16,52] or color-coded TDI [53,54], can be better quantified than wall motion assessed by M-mode echocardiography, and with high temporal resolution. The ratio of the two wall motion velocities during diastole (Ew/Aw) in young normal individuals is >1.…”

Section: Diastolic 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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“…Tissue Doppler echocardiography has been widely used to quantify regional myocardial function by measuring tissue velocities [1][2][3][4][5][6]. However, regional Doppler tissue velocities in one area are affected by motion of the adjacent regions as well as the whole heart translational motion [7][8][9].…”

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Quantitative Assessment of Wall Motion Using Myocardial Strain

et al. 2003

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Background: Since regional tissue velocities are affected by motion of the adjacent regions as well as the whole heart translational motion, the quantification of wall motion using conventional tissue Doppler method may be questionable.Recently, a new echocardiographic system which enables the calculation of myocardial strain based on tissue Doppler information has been developed. Methods:We investigated whether myocardial strain could quantify regional myocardial contraction in 13 patients with normal wall motion and in 18 patients with wall motion abnormalities. Left ventricular segmental wall motion was assessed with conventional 2-dimensional echocardiography at the apical 2-, 3-, and 4-chamber views. The same views were imaged also with tissue Doppler method to determine regional systolic myocardial strain.Results: By 2-dimensional echocardiography, 230 segments were judged normokinesis, 83 segments hypokinesis and 23 segments showed akinesis. No segments showed dyskinesis. Peak systolic strain values of normokinetic, hypokinetic and akinetic wall segments were significantly different from each other (-20.1±5.5% for normokinesis, -11.9±5.0% for hypokinesis, p<0.0001 vs. normokinesis, and -6.3±3.4% for akinesis, p<0.0001 vs. normokinesis and p<0.0001 vs. hypokinesis) without significant overlap. Peak systolic strain values in normal subjects were similar among all segments, suggesting insignificant regional variations (p=ns). Conclusion:Systolic myocardial strain agreed well with assessed wall motion. Myocardial strain imaging may be a new powerful tool to quantify regional wall contraction. (J Echocardiogr 2003; 1: 23-28)

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Color-coded measures of myocardial velocity throughout the cardiac cycle by tissue Doppler imaging to quantify regional left ventricular function

Cited by 210 publications

References 22 publications

Quantification of Left Ventricular Systolic Function by Tissue Doppler Echocardiography

Quantification of Left Ventricular Systolic Function by Tissue Doppler Echocardiography

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

Quantitative Assessment of Wall Motion Using Myocardial Strain

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