Original article
Doppler tissue echocardiography: can transesophageal echocardiography be used to acquire functional data?

https://doi.org/10.1016/S0894-7317(03)00322-5Get rights and content

Abstract

Background

To date there is no direct comparison of transesophageal and transthoracic Doppler tissue data in patients with cardiac malposition. We compared data acquired from both methods in an animal model.

Method

We studied 10 15-kg Yorkshire pigs during incremental atrial pacing to modify myocardial responses. Peak isovolumic velocity (IVV) and isovolumic acceleration (IVA) during isovolumic contraction, ejection (S wave), and diastolic velocities (early passive and active filling, E and A wave, respectively) were measured.

Results

Bland-Altman plots showed comparable values for IVA, IVV, and E velocity using both methods. Measurements of A velocities were significantly different. S wave velocity measurements were significantly different in animals with cardiac malposition but not in those with levocardia. Malposition did not significantly effect measurements of IVA or IVV by either technique.

Conclusion

Assessment of systolic function using the indices IVA and IVV by tranesophageal and transthoracic echocardiography are comparable. The tranesophageal assessment of velocities associated with greater degrees of myocardial shortening or lengthening cannot be directly compared with measurements derived from a transthoracic approach in patients with cardiac malposition.

Section snippets

Methods

We studied 10 15-kg Yorkshire pigs. The study conformed to the guidelines of the American Heart Association for animal research experiments. After premedication with midazolam (0.3 mg/kg) and acepromazine (3 mg/kg), the animals were endotracheally intubated and ventilated with a ventilator (Ventimeter, Controller II, Air-Shields, Vickers, Hatbora, Pa). Anesthesia was maintained with isofluorane 2% in a mixture of N2O and oxygen. Arterial blood gases were sampled to ensure adequate ventilation

Results

There were 6 pigs with levocardia, 3 with mesocardia, and 1 with dextrocardia. The maximum heart rate attained in 6 animals was 160 bpm, and 180 bpm in the remaining 4 animals. Higher heart rates were not attained because of the development of mechanical alternans detected by IVA. Ranges of imaging frame rates for TEE and TTE data were 118 to 193/s and 145 to 205/s, respectively.

Mean values are shown in Table 1. There was a tendency for TTE values to be higher than those recorded by TEE. Except

Discussion

Doppler tissue echocardiography is a useful technique to assess ventricular function. We have recently described the Doppler tissue–derived index of myocardial IVA as a noninvasive, relatively load-independent index of systolic function that is applicable to both the LV and right ventricle.7, 8 To further investigate this index and also other Doppler tissue–derived indices, we compared TEE and TTE acquisition of data.

Our data show that values for Doppler tissue data gained from TEE and TTE

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Supported by an unrestricted educational grant from GE Vingmed Ultrasound, Horten, Norway, and by the Heart and Stroke Foundation of Canada.

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