Diastolic function measurements and diagnostic consequences: a comparison of pulsed wave- and color-coded tissue Doppler imaging

INTRODUCTION: Tissue Doppler imaging (TDI) plays an important role in assessing diastolic function using echocardiography. However, two different methods [pulsed wave (PW-TDI) and color-coded (CC-TDI)] are currently used. We aimed to compare both measurements. METHODS: We included 114 patients that were referred to our echocardiography department for evaluation of diastolic left ventricular function. In these patients, we sequentially measured tissue velocities of basal lateral and septal myocardium of the left ventricle in an apical four-chamber view with both PW-TDI and CC-TDI. RESULTS: Our cohort consisted of a heterogeneous group of patients with and without a history of cardiac disease. Mean age of the patients was 52 ± 16.7 years, and 62% were males. We found a strong correlation between PW-TDI- and CC-TDI-derived myocardial velocities (r = 0.93; p = 0.001). However, E′ (mean of lateral and septal) velocities measured with PW-TDI were consistently higher compared to CC-TDI values [PW-TDI E′ 10.3 ± 3.9 (SD) cm/s vs. CC-TDI E′ 7.7 ± 3.1 cm/s; p < 0.001]. From these data, we calculated that the relation between E′ measured with PW-TDI and CC-TDI can be described as: E′ (PW-TDI) = 1.25 + 1.17 × E′ (CC-TDI). Consequently, E/E′ measured with PW-TDI was consistently lower compared with CC-TDI (9.1 ± 3.1 vs. 12.5 ± 5.7; p < 0.001) From these data, we calculated that the relation between E/E′ measured with PW-TDI and CC-TDI can be described as: E/E′ (PW-TDI) = 2.13 + 0.56 × E/E′ (CC-TDI). CONCLUSIONS: Despite a strong correlation, tissue velocities measured with PW-TDI will yield higher values as compared with CC-TDI. This should be taken into account when defining cut-off values for the evaluation of diastolic function.