Evaluation of Hemodynamic Determinants of Quantitative Tissue Doppler Echocardiography in the Assessment of Left...

The aim of the present study was to determine whether quantitative tissue Doppler echocardiography has a role in the assessment of left ventricular hemodynamics. Thirty patients with suspected or known heart disease, but no wall motion abnormalities, took part in the study. Quantitative tissue Doppler echocardiography was performed using new software for digital analysis of the tissue Doppler signal. Average systolic subendocardial (S1), subepicardial (S2), and transmural (S3) wall velocity data were obtained from the inferoposterior wall and compared with the hemodynamics, including high fidelity pressure readings. S1 and S3 rates were found to be most reliable, being directly related to the peak rate of left ventricular pressure rise (dP/dt(peak)) and inversely to systemic vascular resistance (SVR) and resistance index (SVRI). The best correlation was between S1, dP/dt(peak), and SVRI (multiple regression analysis: r = 0.76, P < 0.0001; simple regression analysis relating S1 to dP/dt(peak)/SVRI: r = 0.77, SEE = 0.25, P < 0.0001). Thus, wall velocity indices as defined in this study have promise to become helpful in guiding the therapeutic modulation of inotropy and afterload in patients with heart failure.