Exercise tissue Doppler echocardiography with strain rate imaging in healthy young individuals: feasibility, normal values and reproducibility

Goebel, Björn; Arnold, Raoul; Koletzki, Eric; Ulmer, Herbert E.; Eichhorn, Joachim; Borggrefe, Martin; Figulla, Hans R; Poerner, Tudor C.

doi:10.1007/s10554-006-9159-7

Cited by 6 publications

(11 citation statements)

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“…These results were partly confirmed by another study reporting increased longitudinal motion of the left ventricular myocardium during physical exercise (Saha et al, 2004). A third study used TVI variables to compare different stress types and have reported differences in myocardial velocities in healthy individuals depending on the stress modality used (Goebel et al, 2007). However, there is still a need for more studies to refine the methods and to investigate the appearance of TVI variables during different forms of stress and, in particular, the differences between upright and supine bicycle exercise tests have not been fully investigated.…”

Section: Introductionmentioning

confidence: 67%

Differences in myocardial velocities during supine and upright exercise stress echocardiography in healthy adults

Bjällmark

Larsson

Shahgaldi

et al. 2009

Clin Physio Funct Imaging

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Summary Background: Tissue Velocity Imaging (TVI) is a method for quantitative analysis of longitudinal myocardial velocities, which can be used during exercise and pharmacological stress echocardiography. It is of interest to evaluate cardiac response to different types of stress tests and the differences between upright and supine bicycle exercise tests have not been fully investigated. Therefore, the aim of this study was to compare cardiac response during supine and upright exercise stress tests. Method: Twenty young healthy individuals underwent supine and upright stress test. The initial workload was set to 30 W and was increased every minute by a further 30 W until physical exhaustion. Tissue Doppler data from the left ventricle were acquired at the end of every workload level using a GE Vivid7 Dimension system (>200 frames s−1). In the off‐line processing, isovolumic contraction velocity (IVCV), peak systolic velocity (PSV), isovolumic relaxation velocity (IVRV), peak early diastolic velocity (E’) and peak late diastolic velocity (A’) were identified at every workload level. Result: No significant difference between the tests was found in PSV. On the contrary, E’ was shown to be significantly higher (P<0·001) during supine exercise than during upright exercise and IVRV was significantly lower (P<0·001) during supine exercise compared to upright exercise. Conclusion: Upright and supine exercise stress echocardiography give a comparable increase in measured systolic velocities and significant differences in early diastolic velocities.

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Section: Introductionmentioning

confidence: 67%

Differences in myocardial velocities during supine and upright exercise stress echocardiography in healthy adults

Bjällmark

Larsson

Shahgaldi

et al. 2009

Clin Physio Funct Imaging

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“…This methodology is not optimal since cardiac functional parameters rapidly decline as soon as exercising stops [1]. Only a few studies used it during exercise [5,6,9,12,21]. However, the ability of TDI to provide accurate estimates of LV function during exercising requires the proper assessment of its reproducibility.…”

mentioning

confidence: 99%

“…However, the ability of TDI to provide accurate estimates of LV function during exercising requires the proper assessment of its reproducibility. To the best of our knowledge, only Goebel et al [9] studied the reproducibility of TDI during exercising, but this was completed on 2 subjects performing in the very low-intensity domain (i.e., heart rate at a peak effort of 135 ± 8 b • min -1 in subjects less than 23 years of age). Therefore, further studies are required, especially during moderate to maximal effort, when greater body and respiratory movements could limit good quality image acquisition, thus questioning TDI feasibility and, subsequently, reproducibility.…”

mentioning

confidence: 99%

“…However, TDI reproducibility during exercise is largely dependent on the acquisition of good quality echocardiographic recordings and its reproducibility during effort must thus be questioned. To our knowledge, only Goebel et al [9] evaluated TDI reproducibility in 2 subjects performing a semi-supine constant workload exercise of very low intensity. We are not aware of studies examining the reproducibility of TDI during moderate to maximal effort (a frequent exercise condition in sports medicine or even in clinics), which is still a primary condition for its validity.…”

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confidence: 99%

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Tissue Doppler Imaging Reproducibility during Exercise

Bougault¹,

Noltin²,

Doucende³

et al. 2008

Int J Sports Med

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Tissue Doppler imaging (TDI) is an echocardiographic technique used during exercising to improve the accuracy of a cardiovascular diagnostic. The validity of TDI requires its reproducibility, which has never been challenged during moderate to maximal intensity exercising. The present study was specifically designed to assess the transmitral Doppler and pulsed TDI reproducibility in 19 healthy men, who had undergone two identical semi-supine maximal exercise tests on a cycle ergometer. Systolic (S') and diastolic (E') tissue velocities at the septal and lateral walls as well as early transmitral velocities (E) were assessed during exercise up to maximal effort. The data were compared between the two tests at 40 %, 60 %, 80 % and 100 % of maximal aerobic power. Despite upper body movements and hyperventilation, good quality echocardiographic images were obtained in each case. Regardless of exercise intensity, no differences were noticed between the two tests for all measurements. The variation coefficients for Doppler variables ranged from 3 % to 9 % over the transition from rest to maximal exercise. The random measurement error was, on average, 5.8 cm/s for E' and 4.4 cm/s for S'. Overall, the reproducibility of TDI was acceptable. Tissue Doppler imaging can be used to accurately evaluate LV diastolic and/or systolic function for this range of exercise intensity.

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“…3 Similarly, several reports indicate that regional exerciseinduced left ventricular diastolic dysfunction can be assessed with strain rate, based on color-coded tissue Doppler measurements. [49][50][51] Using conventional Doppler technique, calculation of suction performance may provide additional insight into left ventricular diastolic function during exercise. 52 If these technical advancements can be extended to routine clinical cardiology practice, there could be a quantum leap in our ability to determine the importance of exercise-induced left ventricular diastolic dysfunction as a cause for symptoms such as dyspnea on exertion, fatigue, exercise limitation, and others.…”

Section: Future Directionsmentioning

confidence: 99%

Customized Exercise Echocardiography: Beyond Detection of Coronary Artery Disease

Shizukuda

Plummer²,

Harrelson

2010

Echocardiography

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Exercise echocardiography has been established as a reliable diagnostic tool for assessment of myocardial ischemia. However, more recent advances in its technique have expanded its routine clinical use to include quantification of exercise-induced diastolic dysfunction, exercise-induced pulmonary hypertension, and dynamic assessment of mitral and aortic valve function. The indications for exercise echocardiography have increased to include cardiac symptoms such as exertional dyspnea, fatigue, and limited exercise capacity. In light of its expanded capability for evaluating cardiovascular function, we believe that exercise echocardiography should be utilized in a new paradigm of personalized cardiology, in which we regularly investigate individual patient symptoms for endpoints beyond critical myocardial ischemia, for example, exercise-induced pulmonary hypertension. We refer to this refocused use of exercise echocardiography as "customized exercise echocardiography." In this review article, we present current scientific evidence to support our proposed role and discuss the logistical requirements for proper test performance of customized exercise echocardiography.

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Exercise tissue Doppler echocardiography with strain rate imaging in healthy young individuals: feasibility, normal values and reproducibility

Cited by 6 publications

References 0 publications

Differences in myocardial velocities during supine and upright exercise stress echocardiography in healthy adults

Differences in myocardial velocities during supine and upright exercise stress echocardiography in healthy adults

Tissue Doppler Imaging Reproducibility during Exercise

Customized Exercise Echocardiography: Beyond Detection of Coronary Artery Disease

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