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European Journal of Echocardiography Advance Access published online on April 2, 2008
European Journal of Echocardiography, doi:10.1093/ejechocard/jen130
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

Concordance between M-mode, pulsed Tissue Doppler, and colour Tissue Doppler in the assessment of mitral annulus systolic excursion in normal subjects

Piercarlo Ballo1,*, Arianna Bocelli2, Andrea Motto1 and Sergio Mondillo3

1 Cardiology Operative Unit, S. Andrea Hospital, via Veneto 197, 19100 La Spezia, Italy
2 Meyer Hospital, University of Florence, Florence, Italy
3 Department of Cardiovascular Diseases, University of Siena, Siena, Italy

Received 5 November 2007; .

* Corresponding author. Tel: +39 0187533299; fax: +39 0187533456.E-mail address: pcballo{at}tin.it


  Abstract

Aims: M-mode left atrioventricular plane displacement (AVPD) correlates with Tissue Doppler (TD) peak systolic annular velocity in healthy individuals. This approach is biased by several interacting factors related to the structural complexity of mitral annulus physiology, including the different dimensional values of measures, the confounding effect of isovolumic motions, and the spectral thickness of pulsed TD envelope. We sought to analyze the effective concordance between techniques in the assessment of systolic annular excursion.

Methods and results: In 92 healthy subjects (age 60.5 ± 18.6, 43.5% women), systolic AVPD was measured after exclusion of isovolumic components using three techniques: (i) M-mode; (ii) temporal integration of pulsed TD systolic wave; and (iii) colour TD-derived tissue tracking. Close correlations of M-mode AVPD with pulsed TD velocity-time integral (VTI) (R = 0.90, P < 0.0001) and colour TD AVPD (R = 0.86, P < 0.0001) were found. However, M-mode AVPD underestimated pulsed TD VTI (mean error –5.1 ± 1.7 mm) and overestimated colour TD AVPD (mean error 3.4 ± 1.3 mm). The concordance between M-mode and pulsed TD increased after adjustment for spectral dispersion of pulsed TD istantaneous velocities (mean error 0.1 ± 1.1 mm).

Conclusion: Despite strict correlations exist between M-mode and TD in the assessment of mitral annulus systolic excursion, the effective concordance between techniques is sub-optimal.

Keywords: Doppler Tissue imaging; M-mode; Mitral annular systolic motion


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