Colour tissue Doppler underestimates myocardial velocity as compared to spectral tissue Doppler: poor reliability...

Since colour tissue Doppler (CTD) has been shown to underestimate myocardial velocity, we sought to compare CTD with spectral tissue Doppler (STD) and establish agreement and corresponding thresholds for clinical applications.

We included 52 consecutive patients with sinus rhythm referred for echocardiographic assessment. Analysis involved a commercially available echosonographer (Vivid 7, GE-Vingmed) and the Echopac system for offline assessment. Myocardial velocities were recorded by STD and CTD in a 4-chamber apical view. CTD values were lower than those measured by STD: 6.0 +/- 2.5 versus 8.2 +/- 2.8 for Ea; 5.5 +/- 2.3 versus 7.9 +/- 2.9 for Aa, and 5.4 +/- 2.0 versus 7.7 +/- 2.4 for Sa (P < 0.001 for all). CTD overestimated the E/Ea: 14.7 +/- 7.6 versus 10.1 +/- 4.1, P < 0.001. Reliability between the two methods was low to moderate: kappa values ranged from 0.33 +/- 0.10 to 0.57 +/- 0.12. CTD thresholds corresponding to usual STD thresholds were calculated, but reliability was not significantly increased, except for the E/Ea ratio. By using continuous values, the ability of the Ea, Sa and E/Ea to predict the presence of heart failure in this sample was similar whatever the method.

CTD consistently underestimates myocardial velocity values and overestimates E/Ea. A shift of thresholds between the two methods is not sufficient to obtain good agreement, except when measuring the E/Ea ratio.