Abstract 2122: Head-to-head Comparison Between Tissue Doppler Imaging And Velocity Encoded Magnetic Resonance Imaging For The Measurement Of Myocardial Velocities And The Assessment Of Left Ventricular Dyssynchrony And Diastolic Function.

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Nina Ajmone Marsan ◽  
Jos Westenberg ◽  
Claudia Ypenburg ◽  
Eduard R Holman ◽  
Ernst E van der Wall ◽  
...  

Aim of the study. To compare echocardiographic tissue Doppler imaging (TDI) and velocity encoded (VE) magnetic resonance imaging (MRI) for the measurement of myocardial velocities and the assessment of left ventricular (LV) dyssynchrony and diastolic function. Methods. Ten healthy volounteers (5 men, 31±5 yrs) and 25 heart failure (HF) pts (17 men, 58±11 yrs) underwent both cardiac MRI and TDI. Longitudinal myocardial peak systolic (PSV) and diastolic (PDV) velocities and time to PSV (Ts) and to PDV (Td) were measured at basal and mid level of LV septum and lateral wall. To quantify LV dyssynchrony, delay in Ts between basal septum and lateral wall was calculated (SLD) and pts were categorized in 3 groups according to the extent of LV dyssynchrony by TDI: minimal (SLD<30 ms), intermediate (30 – 60 ms) and extensive (>60 ms) LV dyssynchrony. As a measure of LV diastolic function, the ratio of transmitral E wave velocity and mitral annulus septal early velocity (E/E′) was also calculated and pts were classified in 3 groups: normal LV diastolic function (E/E′ <8), abnormal LV diastolic function (E/E′= 8 –15) and severe LV diastolic dysfunction (E/E′>15). Results. PSV measured with VE-MRI showed excellent correlation with PSV measured with TDI (r=0.94, P<0.001) in both normals and HF pts and Bland-Altman analysis revealed a small bias (MRI-TDI) of 1±1 cm/s (P< 0.001) between both techniques. A strong correlation was also observed between Ts measured with TDI and VE-MRI (r=0.97, P<0.001) without significant bias. Excellent agreement between TDI and VE-MRI was found for LV dyssynchrony classification with a weighted κ=0.96. e′ and A′ PDV measured with VE-MRI correlated very well with PDV measured with TDI (r=0.95, P<0.001) with a small bias of 0.4±1 cm/s (P<0.001) between the 2 techniques. Excellent agreement between TDI and VE-MRI was also observed in classifying LV diastolic function with a weighted k=0.91. A very good correlation has been observed also for Td of E′(r=0.96, P<0.001) and Td of A′ (r=0.88, P<0.001) measured with both techniques. Conclusions. TDI and VE-MRI can be used interchangeably to measure LV myocardial systolic and diastolic velocities and excellent agreement exists between the 2 techniques for LV dyssynchrony and diastolic function classification.

Author(s):  
Gihan M. Bebars ◽  
Hany T. Askalany

Abstract Background Malnourished children endure many changes in body composition and lose heart and skeletal muscle mass. Diastolic dysfunction is one of the major causes of heart failure with preserved ejection fraction. Aim To assess left ventricular systolic and diastolic functions in children with severe acute malnutrition using tissue Doppler imaging technique and to evaluate the effect of nutritional rehabilitation. Patients and Methods A follow-up case-control study conducted on 60 severely malnourished children (WHZ < -3SD) and 120 age and sex-matched healthy children as a control group. Tissue Doppler imaging (TDI) was done for all included malnourished children at admission and for control to measure left ventricular systolic and diastolic functions. Nutritional rehabilitation was done according to WHO protocol and tissue doppler was repeated after rehabilitation when (WHZ > -2SD) to detect any changes in systolic or diastolic functions. Results Systolic function was normal in malnourished children and control. Grade I diastolic dysfunction was detected in 40% and grade II in 30% of severely malnourished children in comparison to 100% normal diastolic function in control group. No correlations between diastolic dysfunction and either anthropometric measurements, electrolyte disturbances or Hb% in malnourished children before nutritional rehabilitation. Mortality from sepsis with associated ventricular dysfunction grade II documented in 3.3% of malnourished children. After nutritional rehabilitation diastolic function improved significantly as 65.6% of children attained normal diastolic function, 31% grade1 and 3.4% grade II. Positive correlations between diastolic function and WAZ, HAZ, WHZ and MUAC after rehabilitation. Conclusion Severe acute malnutrition affects diastolic function in children which is reversible in most of these cases with rehabilitation. TDI is an easy and practical method for detection and follow-up of ventricular function in malnourished children.


Author(s):  
Johan De Sutter ◽  
Jean-Louis J. Vanoverschelde

The evaluation of diastolic function in patients with reduced (HFREF) or preserved (HFPEF) left ventricular (LV) ejection fraction is important as it carries both diagnostic and prognostic information. In daily practice, this is most frequently done by standard echocardiographic techniques, including the evaluation of LV mass and LA volumes, as well as transmitral and pulmonary venous PW Doppler, CW Doppler for evaluation of the IVRT, and tissue Doppler imaging of the septal and lateral annular velocities. This permits grading the severity of diastolic dysfunction, which is related to outcome and may be used to estimate LV filling pressures. The latter needs further validation, especially in patients with HFPEF. Newer echocardiographic and cardiac magnetic resonance techniques, including myocardial deformation measurements during diastole, LV twist and untwisting, and parameters of left atrial function, are promising and will hopefully in the future help clinicians to make a more precise evaluation of diastolic function and filling pressures in heart failure patients.


2015 ◽  
Vol 2015 ◽  
pp. 1-12 ◽  
Author(s):  
Roman Leischik ◽  
Henning Littwitz ◽  
Birgit Dworrak ◽  
Pankaj Garg ◽  
Meihua Zhu ◽  
...  

Left atrial (LA) functional analysis has an established role in assessing left ventricular diastolic function. The current standard echocardiographic parameters used to study left ventricular diastolic function include pulsed-wave Doppler mitral inflow analysis, tissue Doppler imaging measurements, and LA dimension estimation. However, the above-mentioned parameters do not directly quantify LA performance. Deformation studies using strain and strain-rate imaging to assess LA function were validated in previous research, but this technique is not currently used in routine clinical practice. This review discusses the history, importance, and pitfalls of strain technology for the analysis of LA mechanics.


Sign in / Sign up

Export Citation Format

Share Document