Tissue Doppler Imaging in Echocardiography: Value and Limitations

Kadappu, K.; Thomas, Liza

doi:10.1016/j.hlc.2014.10.003

Cited by 121 publications

(114 citation statements)

References 99 publications

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“…One of the most useful aspects of TDI in human and small animal echocardiography has been the ability to detect subtle systolic and diastolic myocardial dysfunction in patients with a wide variety of diseases including ischemic heart disease, dilated and hypertrophic cardiomyopathy, restrictive cardiomyopathy, and constrictive pericarditis 5, 6, 7, 9, 45, 46, 47, 48, 49, 50, 51. While myocardial diseases are considered uncommon and are rarely reported in horses, they might in fact be under‐recognized because of the lack of established diagnostic methods 1.…”

Section: Discussionmentioning

confidence: 99%

Echocardiographic Assessment of Left Ventricular Function in Healthy Horses and in Horses with Heart Disease Using Pulsed‐Wave Tissue Doppler Imaging

Koenig

Mitchell

Schwarzwald

2017

Veterinary Internal Medicne

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BackgroundAssessment of left ventricular (LV) function by tissue Doppler imaging (TDI) is not well established in horses with heart disease.ObjectivesTo describe the use of pulsed‐wave (PW) TDI for the assessment of LV function, establish reference intervals, investigate effects of mitral regurgitation (MR), aortic regurgitation (AR), and primary myocardial disease (MD), and provide proof of concept for the use of PW TDI in Warmblood horses with heart disease.AnimalsThirty healthy horses, 38 horses with MR, 25 with AR, 8 with MD.MethodsEchocardiograms were retrospectively analyzed. Reference intervals were calculated. PW TDI indices of healthy horses and horses with MR, AR, and MD were compared by one‐way ANOVA and Dunnett's test.ResultsA complete set of PW TDI variables could be obtained in 94 of 101 horses. Variables corresponding to isovolumic intervals were most difficult to measure. Valvular regurgitation influenced variables describing isovolumic contraction and ejection. Horses with MD had significantly shortened ETm (−118.5 [−154.1 to −82.9] ms; mean difference [95% CI of difference of means]), increased PEPm/ETm (0.11 [0.05 to 0.17]), prolonged IMPm (0.28 [0.18 to 0.37]), increased S 1 (8.9 [5.2 to 12.6] cm/s), and decreased E 1 (−2.6 [−4.7 to −0.5] cm/s), E m (−14.2 [−19.9 to −8.5] cm/s), and E m/A m ratio (−1.6 [−2.6 to −0.6]).Conclusions and Clinical ImportancePulsed‐wave TDI might be useful for detection of LV dysfunction in horses with primary MD. The clinical value of TDI in horses with MR and AR remains uncertain.

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Section: Discussionmentioning

confidence: 99%

Echocardiographic Assessment of Left Ventricular Function in Healthy Horses and in Horses with Heart Disease Using Pulsed‐Wave Tissue Doppler Imaging

Koenig

Mitchell

Schwarzwald

2017

Veterinary Internal Medicne

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“…Strain can be measured by tissue Doppler imaging (TDI) or by STE. Although TDI can be used to calculate natural myocardial strain, this technique has a number of limitations including angle-dependency, influence of region of interest, and lack of information of global systolic function 17). Currently, STE is the most widely used modality for measuring strain.…”

Section: Discussionmentioning

confidence: 99%

Normal 2-Dimensional Strain Values of the Left Ventricle: A Substudy of the Normal Echocardiographic Measurements in Korean Population Study

Park

Lee

et al. 2016

J Cardiovasc Ultrasound

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BackgroundIt is important to understand the distribution of 2-dimensional strain values in normal population. We performed a multicenter trial to measure normal echocardiographic values in the Korean population.MethodsThis was a substudy of the Normal echOcardiogRaphic Measurements in KoreAn popuLation (NORMAL) study. Echocardiographic specialists measured frequently used echocardiographic indices in healthy people according to a standardized method at 23 different university hospitals. The strain values were analyzed from digitally stored images.ResultsOf a total of 1003 healthy participants in NORMAL study, 2-dimensional strain values were measured in 501 subjects (265 females, mean age 47 ± 15 years old) with echocardiographic images only by GE echocardiographic machines. Interventricular septal thickness, left ventricular (LV) posterior wall thickness, systolic and diastolic LV dimensions, and LV ejection fraction were 7.5 ± 1.0 mm, 7.4 ± 1.0 mm, 29.9 ± 2.8 mm, 48.9 ± 3.6 mm, and 62 ± 4%, respectively. LV longitudinal systolic strain (LS) values of apical 4-chamber (A4C) view, apical 3-chamber (A3C) view, apical 2-chamber (A2C) view, and LV global LS (LVGLS) were −20.1 ± 2.3, −19.9 ± 2.7, −21.2 ± 2.6, and −20.4 ± 2.2%, respectively. LV longitudinal systolic strain rate (LVLSR) values of the A4C view, A3C view, A2C view, and LV global LSR (LVGLSR) were −1.18 ± 0.18, −1.20 ± 0.21, −1.25 ± 0.21, and −1.21 ± 0.21−s, respectively. Females had lower LVGLS (−21.2 ± 2.2% vs. −19.5 ± 1.9%, p < 0.001) and LVGLSR (−1.25 ± 0.18−s vs. −1.17 ± 0.15−s, p < 0.001) values than males.ConclusionWe measured LV longitudinal strain and strain rate values in the normal Korean population. Since considerable gender differences were observed, normal echocardiographic cutoff values should be differentially applied based on sex.

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“…On rare occasions, it is measured invasively using Pressure-Volume (PV) loop analysis. Recently, echocardiography-based tissue Doppler, tissue strain and strain rate imaging have been used clinically to assess contractility; however, these techniques do not provide a contractility measurement of the myocardium independent of factors such as intra-ventricular volume or cardiac motion 1–3 . It has been shown that transverse stiffness, measured using small high frequency indentations, is an index of contractility in beating canine inter-ventricular septum 4 .…”

Section: Introductionmentioning

confidence: 99%

Quantifying Myocardial Contractility Changes Using Ultrasound-Based Shear Wave Elastography

Vejdani‐Jahromi

Freedman

Nagle

et al. 2017

Journal of the American Society of Echocardiography

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BACKGROUND Myocardial contractility, a significant determinant of cardiac function, is valuable for diagnosis and evaluation of treatment in cardiovascular disorders including heart failure. Shear Wave Elasticity Imaging (SWEI) is a newly developed ultrasound-based elastography technique that can directly assess the stiffness of cardiac tissue. The aim of the study was to verify the ability of technique to quantify contractility changes in the myocardium. METHODS In 12 isolated rabbit hearts we made SWEI measurements of systolic stiffness at 5 different coronary perfusion pressures from 0 to 92 mmHg. The changes in coronary perfusion were used to induce acute stepwise reversible changes in cardiac contractility via the Gregg effect. The Gregg effect is the dependency of contractility on coronary perfusion. In 4 of the hearts, we repeated the measurements after delivery of Gadolinium, which is known to block the Gregg effect. RESULTS Systolic stiffness measured by SWEI changed linearly with coronary perfusion pressure with a slope of 0.27 kPa/mmHg (mean of 95% CI, R2=0.73). As expected the change in contractility due to the Gregg effect was blocked by Gadolinium with a significant reduction of the slope to 0.08 kPa/mmHg. CONCLUSION SWEI measurements of systolic stiffness provide an index of contractility in the unloaded isolated rabbit heart. While this study was done under ideal imaging conditions and with non-physiological loading conditions, it reinforces the concept that this ultrasound technique has the potential to provide a direct and noninvasive index of cardiac contractility.

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Tissue Doppler Imaging in Echocardiography: Value and Limitations

Cited by 121 publications

References 99 publications

Echocardiographic Assessment of Left Ventricular Function in Healthy Horses and in Horses with Heart Disease Using Pulsed‐Wave Tissue Doppler Imaging

Echocardiographic Assessment of Left Ventricular Function in Healthy Horses and in Horses with Heart Disease Using Pulsed‐Wave Tissue Doppler Imaging

Normal 2-Dimensional Strain Values of the Left Ventricle: A Substudy of the Normal Echocardiographic Measurements in Korean Population Study

Quantifying Myocardial Contractility Changes Using Ultrasound-Based Shear Wave Elastography

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