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Assessment of left ventricular diastolic function: comparison of Doppler echocardiography and gated blood pool
Insights
Doppler echocardiography and gated blood pool scintigraphy show favorable agreement in assessing left ventricular diastolic filling patterns, particularly early and atrial filling dynamics. However, discrepancies exist in peak filling rate measurements.
Area of Science:
- Cardiology
- Diagnostic Imaging
- Echocardiography
- Nuclear Cardiology
Background:
- Left ventricular diastolic filling patterns are crucial for assessing cardiac function.
- Doppler echocardiography and gated blood pool scintigraphy are non-invasive methods to evaluate diastolic filling.
- Direct comparisons of these two techniques for diastolic function assessment are limited.
Purpose of the Study:
- To compare Doppler echocardiography and gated blood pool scintigraphy in assessing left ventricular diastolic filling patterns.
- To evaluate the correlation between measurements obtained by both imaging modalities.
Main Methods:
- Twenty-five patients underwent both pulsed Doppler echocardiography and gated blood pool scintigraphy.
- Doppler measurements included peak early diastolic velocity, filling times, and integrated diastolic velocity.
- Scintigraphic measurements included normalized peak filling rate and diastolic filling times.
Main Results:
- Strong correlations were observed between Doppler and scintigraphy for fractional filling in early diastole (r=0.84) and atrial systole (r=0.85).
- Excellent agreement was found for the ratio of early to atrial filling (r=0.83), diastolic filling period (r=0.94), and time to peak early diastolic flow (r=0.88).
- Normalized peak filling rate and time to normalized peak filling rate from end-systole showed poor correlation, potentially due to geometric estimation challenges.
Conclusions:
- Doppler echocardiography and scintigraphy are comparable for assessing key aspects of diastolic filling, including early and atrial filling phases.
- Discrepancies in normalized peak filling rate may stem from difficulties in accurately estimating left ventricular volumes and mitral annular area.
- Both techniques provide valuable, albeit partially different, information regarding diastolic function.
Abstract:
Although left ventricular diastolic filling patterns can be examined by both Doppler velocity recordings and gated blood pool scintigraphy, few data exist regarding a comparison of these techniques. Therefore, Doppler echocardiography and scintigraphy were compared in 25 patients. Pulsed Doppler echocardiography was performed using an apical four chamber view with the sample volume at the level of the mitral anulus. Doppler measurements included peak velocity of the early diastolic filling wave, time to peak early diastolic velocity from both end-systole and end-diastole, diastolic time period and diastolic integrated velocity (early, atrial and total). The cross-sectional area of the mitral anulus and the left ventricular end-diastolic volume were estimated from measurements made on the apical four chamber view. Scintigraphic measurements included normalized peak filling rate, time to normalized filling rate from both end-diastole and end-systole, diastolic time period and relative diastolic filling during early and atrial filling. Doppler echocardiography and scintigraphy compared favorably in assessment of fractional filling during early diastole (r = 0.84) and atrial systole (r = 0.85), ratio of early to atrial filling (r = 0.83), diastolic filling period (r = 0.94) and interval from end-diastole to peak early diastolic flow (r = 0.88). Normalized peak filling rate and time to normalized peak filling rate from end-systole did not correlate closely by these two techniques. The differences in normalized peak filling rate may be explained by difficulties in estimating mitral anulus cross-sectional area and left ventricular end-diastolic volume.(ABSTRACT TRUNCATED AT 250 WORDS)