[Tissue Doppler echocardiography--already of clinical significance?]

Tissue Doppler echocardiography has already been available on clinical ultrasound machines for 8 years. Although this echo modality offers important information on regional myocardial function, it has not found widespread clinical application. A major difficulty has been the necessity for time-consuming off-line postprocessing as no clinical information on regional function can be obtained by visual assessment of complex color 2-D Doppler data. In recent years new modalities based on color tissue Doppler have been introduced such as strain/strain rate imaging, tissue tracking, Q-stress-echocardiography. While strain/strain rate imaging offers very precise analysis of regional left ventricular function, it also requires intensive postprocessing, is limited by an unfavorable signal to noise ratio and a major angle dependency. It is therefore unlikely to have a major clinical role in its currently available form. Tissue tracking and Q-stress echocardiography already incorporate data processing into a visually analyzable format. They offer only semi-quantitative data. However, their ease of use will increase the likelihood of more frequent use in clinical practices. Considering the important information which can be derived about regional function at rest and under stress conditions regarding systolic and diastolic function for different disease entities, it is expected that the use of tissue Doppler echocardiography in clinical practice will increase in the future with the availability of easier to use imaging techniques.