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. 2016 Sep 17;14(1):41.
doi: 10.1186/s12947-016-0083-2.

Total average diastolic longitudinal displacement by colour tissue doppler imaging as an assessment of diastolic function

Martina Chantal de Knegt  1 , Tor Biering-Sørensen  2 , Peter Søgaard  3 , Jacob Sivertsen  2 , Jan Skov Jensen  2 , Rasmus Møgelvang  4
Affiliations

Total average diastolic longitudinal displacement by colour tissue doppler imaging as an assessment of diastolic function

Martina Chantal de Knegt et al. Cardiovasc Ultrasound. .

Abstract

Background: The current method for a non-invasive assessment of diastolic dysfunction is complex with the use of algorithms of many different echocardiographic parameters. Total average diastolic longitudinal displacement (LD), determined by colour tissue Doppler imaging (TDI) via the measurement of LD during early diastole and atrial contraction, can potentially be used as a simple and reliable alternative.

Methods: In 206 patients, using GE Healthcare Vivid E7 and 9 and Echopac BT11 software, we determined both diastolic LD, measured in the septal and lateral walls in the apical 4-chamber view by TDI, and the degree of diastolic dysfunction, based on current guidelines. Of these 206 patients, 157 had cardiac anomalies that could potentially affect diastolic LD such as severe systolic heart failure (n = 45), LV hypertrophy (n = 49), left ventricular (LV) dilation (n = 30), and mitral regurgitation (n = 33). Intra and interobserver variability of diastolic LD measures was tested in 125 patients.

Results: A linear relationship between total average diastolic LD and the degree of diastolic dysfunction was found. A total average diastolic LD of 10 mm was found to be a consistent threshold for the general discrimination of patients with or without diastolic dysfunction. Using linear regression, total average diastolic LD was estimated to fall by 2.4 mm for every increase in graded severity of diastolic dysfunction (β = -0.61, p-value <0.001). Patients with LV hypertrophy had preserved total average diastolic LD despite being classified as having diastolic dysfunction. Reproducibility of LD measures was acceptable.

Conclusions: There is strong evidence suggesting that patients with a total average diastolic LD under 10 mm have diastolic dysfunction.

Keywords: Colour tissue Doppler imaging; Diastolic function; Diastolic longitudinal displacement; Echocardiography.

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Figures

Fig. 1
Fig. 1
Image of colour tissue Doppler imaging with septal longitudinal displacement measurements depicted as area under the curve in early and late diastole. s’, peak mitral annular systolic velocity; e’, peak early mitral annular diastolic velocity; a’, peak atrial mitral annular diastolic velocity; AVO, aortic valve opening; AVC, aortic valve closing
Fig. 2
Fig. 2
Total average diastolic longitudinal displacement and the degree of diastolic dysfunction. HF, heart failure
Fig. 3
Fig. 3
Total average diastolic longitudinal displacement in various heart conditions and the degree of diastolic dysfunction HF, heart failure
Fig. 4
Fig. 4
Total average diastolic longitudinal displacement as a function of left ventricular ejection fraction
Fig. 5
Fig. 5
Interchangeability of average systolic displacement and total average diastolic longitudinal displacement. CV, coefficient of variation; SD, standard deviation
Fig. 6
Fig. 6
Roc curves illustrating a parameter’s predictive value of death. e’, early diastolic tissue velocity by TDI measured at the mitral annulus; a’, late diastolic tissue velocity by TDI measured at the mitral annulus; TT-e’, early diastolic displacement measured at the mitral annulus; TT-a’, late diastolic displacement measured at the mitral annulus; LA, left atrial
See this image and copyright information in PMC

References

    1. Tschöpe C, Paulus WJ. Is echocardiographic evaluation of diastolic function useful in determining clinical care? Doppler echocardiography yields dubious estimates of left ventricular diastolic pressures. Circulation. 2009;120(9):810–20. doi: 10.1161/CIRCULATIONAHA.109.869628. - DOI - PubMed
    1. Nagueh SF, Smiseth OA, Appleton CP, Byrd BF, Dokainish H, Edvardsen T, et al. Recommendations for the evaluation of left ventricular diastolic function by echocardiography: an update from the American society of echocardiography and the European association of cardiovascular imaging. J Am Soc Echocardiogr. 2016;29(4):277–314. doi: 10.1016/j.echo.2016.01.011. - DOI - PubMed
    1. Little WC, Oh JK. Echocardiographic evaluation of diastolic function can be used to guide clinical care. Circulation. 2009;120(9):802–9. doi: 10.1161/CIRCULATIONAHA.109.869602. - DOI - PubMed
    1. Petrie MC, Hogg K, Caruana L, McMurray JJV. Poor concordance of commonly used echocardiographic measures of left ventricular diastolic function in patients with suspected heart failure but preserved systolic function: is there a reliable echocardiographic measure of diastolic dysfunction? Heart. 2004;90(5):511–7. doi: 10.1136/hrt.2003.011403. - DOI - PMC - PubMed
    1. Paulus WJ, Tschöpe C, Sanderson JE, Rusconi C, Flachskampf FA, Rademakers FE, et al. How to diagnose diastolic heart failure: a consensus statement on the diagnosis of heart failure with normal left ventricular ejection fraction by the Heart Failure and Echocardiography Associations of the European Society of Cardiology. Eur Heart J. 2007;28(20):2539–50. doi: 10.1093/eurheartj/ehm037. - DOI - PubMed