As the name suggests, tissue doppler imaging helps evaluate movement of tissues. It is useful in evaluating both systolic and diastolic function, though it is more often used to evaluate the latter. Optimal imaging is obtained at high frame rates.
As has been discussed in previous sections, E’ (or Ea) is a tissue doppler assessment of the early diastolic velocity of the mitral annulus is a good indicator of myocardial relaxation.
An E/e’ ratio of <10 is normal and is seen in impaired relaxation. However, an E/e’ ratio of >15 is indicative of a severe or fixed restriction. In addition, it is useful in assessing left ventricular filling pressures.
The main pointer that differentiates constrictive from restrictive physiology is mitral septal movement.
Mitral medial e' > 8cm/sec = Constrictive pericarditis
Mitral medial e' < 6cm/sec = Restrictive cardiomyopathy
Mitral medial e' between 6 - 8 cm = Mixed constriction and restriction
In athlete’s heart, the mitral valve annulus motion is normal as the myocardial function is normal, while this is not the case in the presence of heart disease (such as hypertrophic cardiomyopathy).
Uses of TDI
1. Assessing LV filling pressures
2. Differentiating constrictive pericarditis from restrictive cardiomyopathy
3. Differentiating athlete’s heart and hypertrophic cardiomyopathy
4. LV dyssynchrony assessment - measuring peak contraction times at different parts of the myocardium.
5. RV systolic assessment using Tricuspid Annular Plane Systolic Excursion (TAPSE) - Normal values >2cm.
References
1. Cardim N, Oliveira AG, Longo S, Ferreira T, Pereira A, Reis RP, Correia JM. Doppler tissue imaging: regional myocardial function in hypertrophic cardiomyopathy and in athlete’s heart. J Am Soc Echocardiogr. 2003; 16: 223–232.
2. Nagueh, Sherif F., 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." European Journal of Echocardiography 17.12 (2016): 1321-1360.
As has been discussed in previous sections, E’ (or Ea) is a tissue doppler assessment of the early diastolic velocity of the mitral annulus is a good indicator of myocardial relaxation.
An E/e’ ratio of <10 is normal and is seen in impaired relaxation. However, an E/e’ ratio of >15 is indicative of a severe or fixed restriction. In addition, it is useful in assessing left ventricular filling pressures.
The main pointer that differentiates constrictive from restrictive physiology is mitral septal movement.
Mitral medial e' > 8cm/sec = Constrictive pericarditis
Mitral medial e' < 6cm/sec = Restrictive cardiomyopathy
Mitral medial e' between 6 - 8 cm = Mixed constriction and restriction
In athlete’s heart, the mitral valve annulus motion is normal as the myocardial function is normal, while this is not the case in the presence of heart disease (such as hypertrophic cardiomyopathy).
Uses of TDI
1. Assessing LV filling pressures
2. Differentiating constrictive pericarditis from restrictive cardiomyopathy
3. Differentiating athlete’s heart and hypertrophic cardiomyopathy
4. LV dyssynchrony assessment - measuring peak contraction times at different parts of the myocardium.
5. RV systolic assessment using Tricuspid Annular Plane Systolic Excursion (TAPSE) - Normal values >2cm.
References
1. Cardim N, Oliveira AG, Longo S, Ferreira T, Pereira A, Reis RP, Correia JM. Doppler tissue imaging: regional myocardial function in hypertrophic cardiomyopathy and in athlete’s heart. J Am Soc Echocardiogr. 2003; 16: 223–232.
2. Nagueh, Sherif F., 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." European Journal of Echocardiography 17.12 (2016): 1321-1360.
No comments:
Post a Comment