Doppler tissue imaging in congestive heart failure patients due to diastolic or systolic dysfunction: a comparison with Doppler echocardiography and the atrio-ventricular plane displacement technique

Background: Doppler tissue imaging (DTI) is an echocardiographic technique by which regional contractility, relaxation properties and time intervals a re obtained easily. DTI has been reported to be relatively pre-load indepen dent and could, in comparison with the commonly used mitral pulse wave Dopp ler (MPWD) method, be of clinical interest for identification of patients w ith diastolic dysfunction. The atrio-ventricular plane displacement (AVPD) method is an established technique to assess left ventricular systolic func tion. Aims: To determine the pulsed Doppler DTI-pattern in patients with he art failure and to examine whether it has a similar capacity as MPWD and AV PD to diagnose diastolic dysfunction. Methods: We studied 15 controls witho ut congestive heart failure (CHF), 15 patients with diastolic (EF > 45% + C HF) and 15 patients with systolic (EF < 35% + CHF) left ventricular dysfunc tion and CHF. Results: The DTI maximal velocities during systole (s), early filling wave (e) and atrial filling wave (a), decrease with reduced left V entricular ejection fraction, r = 0.75, r = 0.56 and r = 0.66 (P < 0.001) a nd regional isovolumetric contraction and intraventricular relaxation time measured by DTI are prolonged, r = 0.59 and r = 0.73, respectively (P < 0.0 01). The 15 patients with diastolic heart failure were identified by MPWD o r DTI but only 11 by AVPD with 8, 10 and 9 false-positive, respectively (P < 0.01, P < 0.05 and NS). Conclusions: Regional DTI show a consistent patte rn in patients with left ventricular dysfunction and heart failure. Regiona l DTI has similar accuracy as MPWD in identifying diastolic heart failure p atients and is superior to the AVPD technique. DTI may be a useful diagnost ic tool in diastolic heart failure patients. (C) 2000 European Society of C ardiology. All rights reserved.