Reproducibility of Pulsed Wave Tissue Doppler Echocardiography,☆☆

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Abstract

Four hundred and eighty paired recordings obtained from 16 patients (55 ± 10 yrs; 10 men, 6 women) were analyzed to determine the reproducibility of both acquiring and measuring myocardial velocities recorded by tissue Doppler echocardiography. To assess intraobserver variability, 1 observer recorded and measured the data twice, from the same patients, and to assess interobserver variability, patients were examined by 2 independent observers. For the left ventricle, intraobserver reproducibility was higher when assessing long-axis velocities (± 10% to 16%) than short-axis velocities (± 14% to 24%). For the right ventricle, intraobserver reproducibility was high for the tricuspid annulus (± 9% to 15%), but unsatisfactory for the right ventricular anterior wall (± 21% to 25%). The highest interobserver reproducibilities were obtained for systolic and diastolic velocities of the lateral mitral annulus (± 9% to 17%) and systolic velocity of the tricuspid annulus (±13%). Interobserver reproducibility of the ratio of early-to-late peak diastolic velocities was very low for all investigated sites (± 20% to 52%). With the use of current techniques and software, reproducibility of acquiring and measuring tissue Doppler echocardiography is suboptimal for both systolic and diastolic myocardial velocities. (J Am Soc Echocardiogr 1999;12:492-9.)

Section snippets

Patients

We studied prospectively 16 patients (55 ± 10 years; 10 men, 6 women) referred for radionuclide ventriculography and transthoracic echocardiography. The clinical indication for referral was assessment of myocardial perfusion and global cardiac function. Patients who were not in sinus rhythm or who had clinical evidence of valvular disease, uncompensated heart failure, or unstable coronary heart disease were excluded.

Seven patients were found to have normal results on rest and stress

Recordings

Four hundred eighty paired recordings obtained from 16 patients (5 segments/patient, 3 variables/segment, 240 recordings each for the analysis of intraobserver and interobserver variability) were compared to determine the reproducibility of both acquiring and measuring peak systolic and diastolic myocardial velocities.

Intraobserver Variability (Table 1)

For the left ventricle, intraobserver variability of peak systolic velocities was not more than 15%. It was slightly lower for the long-axis velocities (±12% and ±13% for the

Our Study

To the best of our knowledge, this study is the first to assess reproducibility of both acquiring and measuring systolic and diastolic velocities recorded by TDE in a large number of paired recordings.

In our study the lateral mitral annulus had the best reproducibility for both systolic and diastolic velocities (not more than ±17% and ±20% for systolic and diastolic function, respectively), probably because it is an easy site from which to record and the Doppler angle of incidence is favorable.

Acknowledgements

We are grateful to Dr Frank Dunstan for his advice on statistical analysis.

References (23)

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Dr Vinereanu held a Training Fellowship from the European Society of Cardiology.

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