Copyright © 2001 by the European Society of Cardiology.
Pulsed Doppler tissue imaging of the velocity of tricuspid annular systolic motion. A new, rapid, and non-invasive method of evaluating right ventricular systolic function
pinarováa
íaeka
a 1st Internal Department, St. Anna Hospital, Brno, Czech Republic
b Department of Nuclear Medicine, Zlín, Czech Republic
revised May 11, 2000; accepted May 11, 2000
Abstract
Aims Rapid, accurate, and widely available non-invasive evaluation of right ventricular function still presents a problem. The purpose of the study was to determine whether the parameters derived from Doppler tissue imaging of tricuspid annular motion could be used as indexes of right ventricular function in patients with heart failure.
Methods Standard and pulsed Doppler tissue echocardiography were obtained in 44 patients with heart failure (mean left ventricular ejection fraction 24±7%) and in 30 age- and sex-matched healthy volunteers. The tricuspid annular systolic and diastolic velocities were acquired in apical four-chamber views at the junction of the right ventricular free wall and the anterior leaflet of the tricuspid valve using Doppler tissue imaging. Within 2h of Doppler tissue imaging, the first-pass radionuclide ventriculogram, determining right ventricular ejection fraction and equilibrium gated radionuclide ventriculography single photon emission computed tomography, were performed in all patients.
Results In patients with heart failure, the peak systolic annular velocity was significantly lower and the time from the onset of the electrocardiographic QRS complex to the peak of systolic annular velocity was significantly greater than the corresponding values in healthy subjects (10·3±2·6cm.s–1vs 15·5±2·6cm.s–1, P<0·001, and 198±34ms vs 171±29ms, P<0·01, respectively). There was a good correlation between systolic annular velocity and right ventricular ejection fraction (r=0·648, P<0·001). A systolic annular velocity <11·5cm.s–1predicted right ventricular dysfunction (ejection fraction <45%) with a sensitivity of 90% and a specificity of 85%.
Conclusion We conclude that the evaluation of peak systolic tricuspid annular velocity using Doppler tissue imaging provides a simple, rapid, and non-invasive tool for assessing right ventricular systolic function in patients with heart failure.
Key Words: Doppler tissue imaging, right ventricle, myocardial function, tricuspid annulus
f1 Correspondence: J. Meluzín, MD, 1st Internal Department, St. Anna Hospital, Peka
ská 53, Brno, 656 91, Czech Republic.
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