Pulsed Wave Tissue Doppler(PWTD) recording of myocardial velocities has been w idely used for assessing ventricular function but the output trace has finite th ickness that leads to potential ambiguity in determining ...Pulsed Wave Tissue Doppler(PWTD) recording of myocardial velocities has been w idely used for assessing ventricular function but the output trace has finite th ickness that leads to potential ambiguity in determining velocity and timing. To determine optimal method of measurement of PWTD traces by comparing them with t hose obtained from digitised M mode recorded from the atrioventricular (AV) val ve ring (septal, LV and RV free wall). We studied 100 subjects, 49 normal and 51 with coronary artery disease (15 patients with reduced left ventricular wall mo tion, mean systolic amplitude of LV free wall 0.8±0.3cm),mean age 53±15 years. We recorded AV ring motion using PWTD and M mode echo techniques. PWTD velocit y signals were measured separately at: outer, inner and mid points of the envel ope and compared with peak ve locities obtained from digitised M mode long axis. Peak systolic (S), early d iastolic (E) and late diastolic (A) PWTD velocities at outer, inner and middle e nvelope correlated closely with the corresponding M mode measurements at left, septal and right ventricular free wall. However, only the midpoint S and E wave PWTD signal velocities agreed numerically with those obtained by digitised M mo de velocities; S(left 6.56±1.80 vs. 6.54±1.91 cm/s N.S.); E(left 8.50±3.25 vs . 7.65±3.30 cm/s N.S.). Agreement was somewhat less satisfactory for A wave; le ft 7.40±2.13 vs. 6.23±2.09 cm/s p< 0.05. Atrioventricular valve ring echo prov ides an excellent in vivo calibration model for validating tissue Doppler veloci ty estimates. Since the midpoint of the envelope of the tissue Doppler signal is the most closely related value to that of the digitised M mode, it may be reco mmended as a convention for routine practice.展开更多
Background: The purpose of this study is to assess the impact of hypertension on systolic function and diastolic function using 2-dimensional echocardiography, conventional Doppler imaging of the transmitral inflow, a...Background: The purpose of this study is to assess the impact of hypertension on systolic function and diastolic function using 2-dimensional echocardiography, conventional Doppler imaging of the transmitral inflow, and tissue Doppler imaging(TDI) of the mitral annulus. Methods: From an outpatient clinic population, 414 consecutive patients underwent 2-dimensional echocardiography, conventional Doppler imaging of the transmitral inflow, and TDI of the septal, lateral, inferior, and posterior walls near the mitral annulus. Parameters of systolic left ventricular(LV) function and diastolic LV function were assessed. Patients were divided according to the presence or absence of systemic hypertension(blood pressure ≥140/90mm Hg on ≥3 measurements or treatment with antihypertensive medication). Results: A complete echocardiographic evaluation was obtained in 397 patients. Among these, 269(68%) had hypertension. There was no difference with respect to age between patients with and without hypertension. Patients with hypertension had higher LV mass index and relative wall thickness and lower TDI peak systolic velocity(VS) when compared with patients without hypertension. In addition, indices of diastolic LV function were significantly impaired in hypertensive patients. Conclusions: Quantitative echocardiography using TDI reveals that hypertensive patients with preserved global LV systolic function often have combined impairment of systolic function and diastolic function.展开更多
文摘Pulsed Wave Tissue Doppler(PWTD) recording of myocardial velocities has been w idely used for assessing ventricular function but the output trace has finite th ickness that leads to potential ambiguity in determining velocity and timing. To determine optimal method of measurement of PWTD traces by comparing them with t hose obtained from digitised M mode recorded from the atrioventricular (AV) val ve ring (septal, LV and RV free wall). We studied 100 subjects, 49 normal and 51 with coronary artery disease (15 patients with reduced left ventricular wall mo tion, mean systolic amplitude of LV free wall 0.8±0.3cm),mean age 53±15 years. We recorded AV ring motion using PWTD and M mode echo techniques. PWTD velocit y signals were measured separately at: outer, inner and mid points of the envel ope and compared with peak ve locities obtained from digitised M mode long axis. Peak systolic (S), early d iastolic (E) and late diastolic (A) PWTD velocities at outer, inner and middle e nvelope correlated closely with the corresponding M mode measurements at left, septal and right ventricular free wall. However, only the midpoint S and E wave PWTD signal velocities agreed numerically with those obtained by digitised M mo de velocities; S(left 6.56±1.80 vs. 6.54±1.91 cm/s N.S.); E(left 8.50±3.25 vs . 7.65±3.30 cm/s N.S.). Agreement was somewhat less satisfactory for A wave; le ft 7.40±2.13 vs. 6.23±2.09 cm/s p< 0.05. Atrioventricular valve ring echo prov ides an excellent in vivo calibration model for validating tissue Doppler veloci ty estimates. Since the midpoint of the envelope of the tissue Doppler signal is the most closely related value to that of the digitised M mode, it may be reco mmended as a convention for routine practice.
文摘Background: The purpose of this study is to assess the impact of hypertension on systolic function and diastolic function using 2-dimensional echocardiography, conventional Doppler imaging of the transmitral inflow, and tissue Doppler imaging(TDI) of the mitral annulus. Methods: From an outpatient clinic population, 414 consecutive patients underwent 2-dimensional echocardiography, conventional Doppler imaging of the transmitral inflow, and TDI of the septal, lateral, inferior, and posterior walls near the mitral annulus. Parameters of systolic left ventricular(LV) function and diastolic LV function were assessed. Patients were divided according to the presence or absence of systemic hypertension(blood pressure ≥140/90mm Hg on ≥3 measurements or treatment with antihypertensive medication). Results: A complete echocardiographic evaluation was obtained in 397 patients. Among these, 269(68%) had hypertension. There was no difference with respect to age between patients with and without hypertension. Patients with hypertension had higher LV mass index and relative wall thickness and lower TDI peak systolic velocity(VS) when compared with patients without hypertension. In addition, indices of diastolic LV function were significantly impaired in hypertensive patients. Conclusions: Quantitative echocardiography using TDI reveals that hypertensive patients with preserved global LV systolic function often have combined impairment of systolic function and diastolic function.
