Tissue tracking allows rapid and accurate visual evaluation of left ventricular function

To evaluate the ability of tissue tracking for rapid assessment of left ventricular function by determination of the systolic mitral annular displacement. Tissue tracking is a new echocardiographic modality based on Doppler Tissue imaging allowing rapid visual assessment of the systolic baso-apical displacement of each myocardial segment in apical views by a graded colour display.

We studied 90 patients (69 male, age 60.4 +/- 10.1 years) with different left ventricular function (25 subjects with normal left ventricular function, 25 patients with homogeneous depression of left ventricular function and 40 patients with prior myocardial infarction). Systolic mitral annular displacement was determined by tissue tracking and M-mode echocardiography. Apical two-, three- and four-chamber views were used to determine the mitral annular displacement of six sites. Left ventricular ejection fraction was determined by two-dimensional echocardiography using Simpson's rule. Tissue tracking was possible in all patients. In the 50 patients with normal left ventricular function or homogeneous depression of left ventricular function, mean mitral annular displacement correlated closely with mitral annular displacement determined by M-mode (r=0.99,P <0.001) and with left ventricular ejection fraction (r=0.97, P<0.001). Left ventricular ejection fraction < or = 30% could be predicted with a sensitivity of 98% and a specificity of 78% using a cut-off value of 4.8mm for the mitral annular displacement determined by tissue tracking. In patients with prior myocardial infarction correlation between the mean mitral annular displacement and left ventricular ejection fraction was lower (r=0.87, P<0.001).

Systolic mitral annular displacement determined by tissue tracking correlates closely with mitral annular displacement determined by M-mode and with left ventricular ejection fraction. Thus, tissue tracking allows rapid semiquantitative evaluation of global left ventricular function by assessment of systolic mitral annular displacement.