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DOI: 10.1055/s-2007-965356
© Georg Thieme Verlag KG Stuttgart · New York
Tissue Doppler Imaging Reproducibility during Exercise
Publication History
accepted after revision March 29, 2007
Publication Date:
19 September 2007 (online)
Abstract
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.
Key words
tissue Doppler imaging - reproducibility - exercise - left ventricle
References
- 1 Armstrong W F, Zoghbi W A. Stress echocardiography: current methodology and clinical applications. J Am Coll Cardiol. 2005; 45 1739-1747
- 2 Atkinson G, Nevill A M. Selected issues in the design and analysis of sport performance research. J Sports Sci. 2001; 19 811-827
- 3 Bland J M, Altman D G. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986; 1 307-310
- 4 Bruch C, Grude M, Müller J, Breithardt G, Wichter T. Usefulness of tissue Doppler imaging for estimation of left ventricular filling pressures in patients with systolic and diastolic heart failure. Am J Cardiol. 2005; 95 892-895
- 5 Burgess M I, Jenjins C, Sharman J E, Marwick T H. Diastolic stress echocardiography: hemodynamic validation and clinical significance of estimation of ventricular filling pressure with exercise. J Am Coll Cardiol. 2006; 47 1891-1900
- 6 D'Andrea A, Caso P, Galderisi M, Di Maggio D, Cicala S, D'Andrea L, Mininni N, Calabro R. Assessment of myocardial response to physical exercise in endurance competitive athletes by pulsed Doppler tissue imaging. Am J Cardiol. 2001; 87 1226-1230
- 7 Galiuto L, Ignone G, DeMaria A. Contraction and relaxation velocities of the normal left ventricle using pulsed-wave tissue Doppler echocardiography. Am J Cardiol. 1998; 81 609-614
- 8 Glüer C C, Blake G, Lu Y, Blunt B A, Jergas M, Genant H K. Accurate assessment of precision errors: how to measure the reproducibility of bone densitometry techniques. Osteoporos Int. 1995; 5 262-270
- 9 Goebel B, Arnold R, Koletzki E, Ulmer H E, Eichhorn J, Borggrefe M, Fiqulla H R, Poerner T C. Exercise tissue Doppler echocardiography with strain rate imaging in healthy young individuals: feasibility, normal values and reproducibility. Int J Cardiovasc Imaging. 2007; 23 149-155
- 10 Gulati M, McBride P E. Functional capacity and cardiovascular assessment: submaximal exercise testing and hidden candidates for pharmacologic stress. Am J Cardiol. 2005; 96 11J-19J
- 11 Ha J W, Lulic F, Bailey K R, Pellikka P A, Seward J B, Tajik A J, Oh J K. Effects of treadmill exercise on mitral inflow and annular velocities in healthy adults. Am J Cardiol. 2003; 91 114-115
- 12 Ha J W, Oh J K, Pellikka P A, Ommen S R, Stussy V L, Bailey K R, Seward J B, Tajik A J. Diastolic stress echocardiography: a novel noninvasive diagnostic test for diastolic dysfunction using supine bicycle echocardiography. J Am Soc Echocardiogr. 2005; 18 63-68
- 13 Isaaz K. What are we actually measuring by Doppler tissue imaging?. J Am Coll Cardiol. 2000; 36 897-899
- 14 Jones C J, Raposo L, Gibson D G. Functional importance of the long axis dynamics of the human left ventricle. Br Heart J. 1990; 63 215-220
- 15 Libonati J R. Exercise training improves left ventricular isovolumic relaxation. Med Sci Sports Exerc. 2000; 22 1399-1405
- 16 Nagueh S F, Middleton K J, Kopelen H A, Zoghbi W A, Quinones M A. Doppler tissue imaging: a noninvasive technique for evaluation of left ventricular relaxation and estimation of filling pressures. J Am Coll Cardiol. 1997; 30 1527-1533
- 17 Nikitin N P, Witte K KA, Ingle L, Clark A L, Farnsworth T A, Cleland J GF. Longitudinal myocardial dysfunction in healthy older subjects as a manifestation of cardia ageing. Age Ageing. 2005; 34 343-349
- 18 Ommen S R, Nishimura R A, Appleton C P, Miller F A, Oh J K, Redfield M M, Tajik A J. Clinical utility of Doppler echocardiography and tissue Doppler imaging in the estimation of left ventricular filling pressures. Circulation. 2000; 102 1788-1794
- 19 Pasquet A, Armstrong G, Rimmerman C, Marwick T. Correlation of myocardial Doppler velocity response to exercise with independent evidence of myocardial ischemia by dual-isotope single-photon emission computed tomography. Am J Cardiol. 2000; 85 536-542
- 20 Popovic Z B, Prasad A, Garcia M J, Arbab-Zadeh A, Borowski A, Dijk E, Greenberg N L, Levine B D, Thomas J D. Relationship among diastolic intraventricular pressure gradients, relaxation, and preload: impact of age and fitness. Am J Physiol. 2006; 290 H1554-H1559
- 21 Saha S K, Brodin L A, Lind B, Svedenhag J, Straat E, Gunnes S. Myocardial velocities measured during adenosine, dobutamine and supine bicycle exercise: a tissue Doppler study in healthy volunteers. Clin Physiol Funct Imaging. 2004; 24 281-288
- 22 Skaluba S J, Litwin S E. Mechanisms of exercise intolerance. Insights from tissue Doppler imaging. Circulation. 2004; 109 972-977
- 23 Sohn D W, Chai I H, Lee D J, Kim H C, Kim H S, Oh B H, Lee M M, Park Y B, Choi Y S, Seo Y D, Lee Y W. Assessment of mitral annulus velocity by Doppler tissue imaging in the evaluation of left ventricular diastolic function. J Am Coll Cardiol. 1997; 30 474-480
- 24 Stoylen A, Wisloff U, Slordahl S. Left ventricular mechanics during exercise: a Doppler and tissue Doppler study. Eur J Echocardiogr. 2004; 4 286-291
- 25 Vinereanu D, Florescu N, Sculthorpe N, Tweddel A C, Stephens M R, Fraser A G. Left ventricular long-axis diastolic function is augmented in the hearts of endurance-trained compared with strength-trained athletes. Clin Sci. 2002; 103 249-257
- 26 Witte K KA, Nikitin N P, De Silva R, Cleland J GF, Clark A L. Exercise capacity and cardiac function assessed by tissue Doppler imaging in chronic heart failure. Heart. 2004; 90 1144-1150
Dr. PhD Valerie Bougault
University of Avignon
Department of Sciences
74 rue Louis Pasteur
84029 Avignon
France
Email: bougaultv@yahoo.fr