Spectral pulsed tissue doppler imaging in diastole: A tool to increase our insight in and assessment of diastolic relaxation of the left ventricle

• Published in: The American heart journal Vol. 146; no. 3; pp. 411 - 419
• Main Authors: De Boeck, Bart W.L, Cramer, Maarten-Jan M, Oh, Jae K, van der Aa, Ronald P.L.M, Jaarsma, Wybren
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.09.2003; Elsevier; Elsevier Limited
• Subjects: Accuracy; Biological and medical sciences; Cardiology; Cardiology. Vascular system; Cardiomyocytes; Coronary Disease - diagnostic imaging; Coronary Disease - physiopathology; Diastole - physiology; Echocardiography, Doppler - methods; Heart failure; Humans; Medical sciences; Mitral Valve - diagnostic imaging; Mitral Valve - physiology; Myocardial Contraction - physiology; Myocardial Ischemia - diagnostic imaging; Myocardial Ischemia - physiopathology; Ventricular Function, Left - physiology; Sonography; Doppler ultrasound study; Relaxation; Tissue; Diastole; Heart disease; Cardiovascular disease; Medical imagery; Increase; Left ventricle
• ISSN: 0002-8703; 1097-6744
• DOI: 10.1016/S0002-8703(03)00322-3

Conventional Doppler echocardiography offers an indirect assessment of left ventricular (LV) diastolic function, hampered by preload dependency. Tissue Doppler imaging (TDI) is a tool to study diastolic function in a more direct and less preload-dependent manner. The Medline database has been searched for literature on TDI for the analysis of diastolic function. A secondary search reviewed the relevant references related to TDI or diastolic function in general. TDI measures myocardial velocities with a high temporal and velocity resolution but lacks spatial information. In particular, the velocity of early diastolic wall motion (E m) and its timing are promising indices of local myocardial relaxation. E m at the mitral annulus offers fair estimates of ventricular relaxation, relatively independent of preload and systolic function. Combined with early transmitral flow velocity (E), detection of pseudo-normalized filling patterns and estimation of filling pressures are enhanced by E/E m. TDI has an emerging role in the study and assessment of diastolic function. However, TDI-derived information needs to be integrated with other echocardiographic data because single diagnostic accuracy remains unsatisfactory.