Normative reference values for the tissue Doppler imaging parameters of left ventricular function: a population-based...

Area of Science:

• Cardiology
• Medical Imaging
• Physiology

Background:

• Tissue Doppler imaging (TDI) is a standard echocardiographic technique for evaluating left ventricular (LV) function and filling pressures.
• Current clinical practice lacks established percentile-based normative reference values for key TDI-derived parameters.
• Accurate reference ranges are essential for reliable interpretation of LV function and filling pressures.

Purpose of the Study:

• To derive and present percentile-based normative reference values for TDI parameters in a healthy adult population.
• To establish age-specific reference ranges for myocardial systolic velocity (Sa), diastolic velocity (Ea), and the E/Ea ratio.
• To facilitate standardized assessment of LV function using echocardiography.

Main Methods:

• Analysis of 453 healthy subjects aged 35-75 from the London Life Sciences Prospective Population (LOLIPOP) study.
• Exclusion of individuals with cardiovascular disease, risk factors, or significant coronary artery disease.
• 2D and Doppler echocardiography, including TDI at septal and lateral mitral annular sites to measure Sa, Ea, and E/Ea.

Main Results:

• Established 5th and 95th percentile reference ranges for septal, lateral, and average Sa, Ea, and E/Ea.
• Demonstrated a significant age-related decline in average Ea velocity (P < 0.001) and Sa velocity (P = 0.04).
• Observed a significant age-related increase in the average E/Ea ratio (P < 0.001).

Conclusions:

• The derived reference ranges for TDI parameters (Sa, Ea, E/Ea) provide essential benchmarks for clinical use.
• These ranges will aid in standardizing the interpretation of echocardiographic assessments of LV function.
• Standardization through these reference values enhances the diagnostic accuracy of tissue Doppler echocardiography.