Tissue Doppler imaging reproducibility during exercise

Tissue Doppler imaging (TDI) is an echocardiographic technique used during exercising to improve the accuracy of a cardiovascular diagnostic. The validity of TDI requires its reproducibility, which has never been challenged during moderate to maximal intensity exercising. The present study was specifically designed to assess the transmitral Doppler and pulsed TDI reproducibility in 19 healthy men, who had undergone two identical semi-supine maximal exercise tests on a cycle ergometer. Systolic (S') and diastolic (E') tissue velocities at the septal and lateral walls as well as early transmitral velocities (E) were assessed during exercise up to maximal effort. The data were compared between the two tests at 40 %, 60 %, 80 % and 100 % of maximal aerobic power. Despite upper body movements and hyperventilation, good quality echocardiographic images were obtained in each case. Regardless of exercise intensity, no differences were noticed between the two tests for all measurements. The variation coefficients for Doppler variables ranged from 3 % to 9 % over the transition from rest to maximal exercise. The random measurement error was, on average, 5.8 cm/s for E' and 4.4 cm/s for S'. Overall, the reproducibility of TDI was acceptable. Tissue Doppler imaging can be used to accurately evaluate LV diastolic and/or systolic function for this range of exercise intensity.