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Assessment of global left ventricular function by tissue Doppler imaging

2001; Elsevier BV; Volume: 88; Issue: 8 Linguagem: Inglês

10.1016/s0002-9149(01)01912-9

1879-1913

Kenji Harada, Masamichi Tamura, Manatomo Toyono, Katsuyuki Oyama, Goro Takada,

Cardiomyopathy and Myosin Studies

Recently, an easily measured Doppler index of combined systolic and diastolic ventricular myocardial performance (the Tei index) was proposed as a potentially useful predictor of global cardiac function. 1 Tei C. New noninvasive index for combined systolic and diastolic ventricular function. J Cardiol. 1995; 26: 135-136 PubMed Google Scholar , 2 Tei C. Dujardin K.S. Hodge D.O. Kyle R.A. Tajik A.J. Seward J.B. Doppler index combining systolic and diastolic myocardial performance Clinical value in cardiac amyloidosis. J Am Coll Cardiol. 1995; 28: 658-664 Abstract Full Text PDF Google Scholar , 3 Tei C. Nishimura R.A. Seward J.B. Tajik A.J. Noninvasive Doppler-derived myocardial performance index Correlation with simultaneous measurements of cardiac catheterization measurements. J Am Soc Echocardiogr. 1995; 10: 169-178 Abstract Full Text Full Text PDF Scopus (719) Google Scholar , 4 Eiden B.W. Tei C. O'Leary P.W. Cetta F. Seward J.B. Nongeometric quantitative assessment of right and left ventricular function Myocardial performance index in normal children and patients with Ebstein anomaly. J Am Soc Echocardiogr. 1995; 12: 849-856 Google Scholar , 5 Eto G. Ishii M. Tei C. Tsutsumi T. Akagi T. Kato H. Assessment of global left ventricular function in normal children and in children with dilated cardiomyopathy. J Am Soc Echocardiogr. 1995; 12: 1058-1064 Abstract Full Text Full Text PDF Scopus (93) Google Scholar , 6 Eiden B.W. O'Leary P.W. Tei C. Seward J.B. Usefulness of the myocardial performance index for assessing right ventricular function in congenital heart disease. Am J Cardiol. 1995; 86: 654-658 Abstract Full Text Full Text PDF Scopus (254) Google Scholar , 7 Williams R.V. Ritter S. Tani L.Y. Pagotto L.T. Minich L.L. Quantitative assessment of ventricular function in children with single ventricles using the Doppler myocardial performance index. Am J Cardiol. 1995; 86: 1106-1110 Abstract Full Text Full Text PDF Scopus (84) Google Scholar , 8 Ishii M. Tsutsumi T. Himeno W. Eto G. Furui J. Hashino K. Sugahara Y. Muta H. Akagi T. Ando A. Eguchi H. Kato H. Sequential evaluation of left ventricular myocardial performance in children after anthracycline therapy. Am J Cardiol. 1995; 86: 1279-1281 Abstract Full Text Full Text PDF Scopus (56) Google Scholar , 9 Sato T. Harada K. Tamura M. Watanabe A. Ishii M. Takada G. Cardiorespiratory exercise capacity and its relation to a new Doppler index in children previously treated with anthracycline. J Am Soc Echocardiogr. 1995; 14: 256-263 Abstract Full Text Full Text PDF Scopus (29) Google Scholar , 10 Eidem B.W. Sapp B.G. Suarez C.R. Cetta F. Usefulness of the myocardial performance index for early detection of anthracycline-induced cardiotoxicity in children. Am J Cardiol. 1995; 87: 1120-1122 Abstract Full Text Full Text PDF Scopus (76) Google Scholar This index is defined as , where a is the interval between end and onset of the mitral inflow, and b is the ejection time of left ventricular (LV) outflow (Figure 1). However, there is an important limitation in that the interval between the end and the onset of mitral inflow and ejection time is measured sequentially and not on the same cardiac cycle. Because of this, results are probably less reliable in the presence of heart rate fluctuation. Tissue Doppler imaging (TDI), however, enables us to simultaneously measure contraction and relaxation velocities from myocardium. 11 Isaaz K. del Romeral L.M. Lee E. Schiller N.B. Quantitation of the motion of the cardiac base in normal subjects by Doppler echocardiography. J Am Soc Echocardiogr. 1995; 6: 166-176 Abstract Full Text PDF Scopus (178) Google Scholar , 12 Rychik J. Tian Z.-Y. Quantitative assessment of myocardial tissue velocities in normal children with Doppler tissue imaging. Am J Cardiol. 1995; 77: 1254-1257 Abstract Full Text PDF Scopus (117) Google Scholar , 13 Harada K. Tsuda A. Orino T. Tanaka T. Takada G. Tissue Doppler imaging in the normal fetus. Int J Cardiol. 1995; 71: 227-234 Abstract Full Text Full Text PDF Scopus (121) Google Scholar , 14 Harada K. Orino T. Yasuoka K. Tamura M. Takada G. Tissue Doppler imaging of left and right ventricles in normal children. Tohoku J Exp Med. 1995; 191: 21-29 Crossref Scopus (69) Google Scholar Mitral annular velocities obtained from the apical 2-chamber view show 3 major distinctive waves: a positive wave toward the apex during systole (S) and 2 waves away from the transducer during diastole. The first diastolic wave occurs during early filling, and the second corresponds to atrial contraction. Using TDI, the time interval between the end and the onset of mitral annular velocities during diastole (a") minus the duration of the S wave (b") divided by b" (i.e., ) (Figure 2) may approximate the Tei index obtained by the conventional Doppler method. This study compares the modified Tei index by TDI with the Tei index by the conventional Doppler method. FIGURE 2Time intervals of the modified myocardial performance index. The a" is the time interval between end and onset of mitral annular diastolic velocities. The b" is the duration of mitral annular systolic velocity. The modified Tei index was calculated as . A = late diastolic wave; E = early diastolic wave; S = systolic wave. View Large Image Figure Viewer