Assessment of diastolic function by tissue Doppler echocardiography: Comparison with standard transmitral and pulmonary venous flow

The objective of this study was to determine the utility of Doppler tissue echocardiography in the evaluation of diastolic filling and in discriminati ng between normal subjects and those with various stages of diastolic dysfu nction. We measured myocardial velocities in 51 patients with various stage s of diastolic dysfunction and in 27 normal volunteers. The discriminating power of each of the standard Doppler indexes of left ventricular filling, pulmonary venous now, and myocardial velocities was determined with the use of Spearman rank correlation and analysis of variance F statistics. Early diastolic myocardial velocity (E-m) was higher in normal subjects (16.0 +/- 3.8 cm/s) than in patients with either delayed relaxation (n = 15, 7.5 +/- 2.2 cm/s), pseudonormal filling (n = 26, 7.6 +/- 2.3 cm/s), Or restrictive filling (n = 10, 7.4 +/- 2.4 cm/s, P < .0001). E-m was the best single dis criminator between control subjects and patients with diastolic dysfunction (P = .7, F = 64.5). Myocardial velocities assessed by Doppler tissue echoc ardiography are useful in differentiating patients with normal from those w ith abnormal diastolic function. Myocardial velocity remains reduced even i n those stages of diastolic dysfunction characterized by increased preload compensation.