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European Journal of Echocardiography 2008 9(2):268-272; doi:10.1016/j.euje.2007.03.036
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2007. For permissions please email: journals.permissions@oxfordjournals.org

Colour tissue Doppler underestimates myocardial velocity as compared to spectral tissue Doppler: Poor reliability between both methods

Jean-Michel Tartière1,*, Damien Logeart2, Lamia Tartière-Kesri2 and Alain Cohen-Solal2

1 Department of Physiology, Assistance Publique, AP-HP, Lariboisière Hospital, 2 rue Ambroise Paré, 75475 Paris, France
2 Department of Cardiology, Assistance Publique, AP-HP, Lariboisière Hospital, 2 rue Ambroise Paré, 75475 Paris, France

Received 24 January 2007; accepted after revision 25 March 2007; online publish-ahead-of-print 9 July 2007.

* Corresponding author. Tel: +33 (0)1 4995 8088; fax: +33 (0)1 4995 8671. E-mail address: jean-michel.tartiere{at}lrb.aphp.fr (J.-M. Tartière).


  Abstract

Aims: Since colour tissue Doppler (CTD) has been shown to underestimate myocardial velocity, we sought to compare CTD with spectral tissue Doppler (STD) and establish agreement and corresponding thresholds for clinical applications.

Methods and results: We included 52 consecutive patients with sinus rhythm referred for echocardiographic assessment. Analysis involved a commercially available echosonographer (Vivid 7, GE-Vingmed) and the Echopac system for offline assessment. Myocardial velocities were recorded by STD and CTD in a 4-chamber apical view.

CTD values were lower than those measured by STD: 6.0 ± 2.5 versus 8.2 ± 2.8 for Ea; 5.5 ± 2.3 versus 7.9 ± 2.9 for Aa, and 5.4 ± 2.0 versus 7.7 ± 2.4 for Sa (P < 0.001 for all). CTD overestimated the E/Ea: 14.7 ± 7.6 versus 10.1 ± 4.1, P < 0.001. Reliability between the two methods was low to moderate: kappa values ranged from 0.33 ± 0.10 to 0.57 ± 0.12. CTD thresholds corresponding to usual STD thresholds were calculated, but reliability was not significantly increased, except for the E/Ea ratio. By using continuous values, the ability of the Ea, Sa and E/Ea to predict the presence of heart failure in this sample was similar whatever the method.

Conclusion: CTD consistently underestimates myocardial velocity values and overestimates E/Ea. A shift of thresholds between the two methods is not sufficient to obtain good agreement, except when measuring the E/Ea ratio.

Keywords: Tissue Doppler; Echography; Heart failure; Diastolic function; Agreement


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