TY - JOUR
T1 - Role of tissue doppler imaging for detection of diastolic dysfunction in the elderly
T2 - A study in clinical practice
AU - Negri, Francesca
AU - Sala, Carla
AU - Valerio, Cristiana
AU - Mancia, Giuseppe
AU - Cuspidi, Cesare
PY - 2011
Y1 - 2011
N2 - Background: The role of tissue Doppler imaging (TDI) in the assessment of diastolic dysfunction in elderly patients seen in echocardiographic practice is poorly defined. Objective: The aim of this study was to investigate the prevalence of diastolic dysfunction in a cohort of elderly patients referred to an echocardiographic examination for routine clinical indications and to compare the findings obtained by conventional Doppler with those obtained by TDI. Methods: A total of 457 elderly patients with preserved left ventricular (LV) systolic function (mean age 73 - 5 years, 45% men, 76% with hypertension) underwent a comprehensive echo-Doppler examination; diastolic dysfunction was defined by the following conventional and TDI criteria: E/A ratio (ratio between transmitral peak velocity of E andAwaves) 1.5 and lateral annular early diastolic peak velocity (Ei) 1.5. A higher proportion of participants (60.1%) had LV diastolic dysfunction according to TDI. Notably, more than one-half of the patients with 'normal' diastolic function by conventional criterion exhibited an abnormal Ei value. Conclusions: A large proportion of elderly patients with normal E/A ratios may have more subtle alterations in LV diastolic mechanics characterized by a reduced annular motion velocity. Thus, evaluation of diastolic function by the simple E/Aratio may markedly underestimate diastolic abnormalities. This finding supports the view that diastolic function should be routinely assessed by comprehensive Doppler methodologies including both conventional and tissue Doppler measurements in order to improve the management of elderly patients seen in clinical practice.
AB - Background: The role of tissue Doppler imaging (TDI) in the assessment of diastolic dysfunction in elderly patients seen in echocardiographic practice is poorly defined. Objective: The aim of this study was to investigate the prevalence of diastolic dysfunction in a cohort of elderly patients referred to an echocardiographic examination for routine clinical indications and to compare the findings obtained by conventional Doppler with those obtained by TDI. Methods: A total of 457 elderly patients with preserved left ventricular (LV) systolic function (mean age 73 - 5 years, 45% men, 76% with hypertension) underwent a comprehensive echo-Doppler examination; diastolic dysfunction was defined by the following conventional and TDI criteria: E/A ratio (ratio between transmitral peak velocity of E andAwaves) 1.5 and lateral annular early diastolic peak velocity (Ei) 1.5. A higher proportion of participants (60.1%) had LV diastolic dysfunction according to TDI. Notably, more than one-half of the patients with 'normal' diastolic function by conventional criterion exhibited an abnormal Ei value. Conclusions: A large proportion of elderly patients with normal E/A ratios may have more subtle alterations in LV diastolic mechanics characterized by a reduced annular motion velocity. Thus, evaluation of diastolic function by the simple E/Aratio may markedly underestimate diastolic abnormalities. This finding supports the view that diastolic function should be routinely assessed by comprehensive Doppler methodologies including both conventional and tissue Doppler measurements in order to improve the management of elderly patients seen in clinical practice.
KW - conventional Doppler
KW - diastolic function
KW - elderly.
KW - tissue Doppler imaging
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U2 - 10.2165/11593610-000000000-00000
DO - 10.2165/11593610-000000000-00000
M3 - Article
C2 - 22283673
AN - SCOPUS:84856375960
VL - 18
SP - 187
EP - 193
JO - High Blood Pressure and Cardiovascular Prevention
JF - High Blood Pressure and Cardiovascular Prevention
SN - 1120-9879
IS - 4
ER -