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Role of tissue Doppler imaging for detection of diastolic dysfunction in the elderly: a study in clinical practice.
MedLine Citation:
PMID:  22283673     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
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 and A waves) <0.7 or >1.5 and lateral annular early diastolic peak velocity (Ei) <8 cm/sec, respectively. Results: Diastolic dysfunction was present in 130 patients (28.4%) according to the conventional Doppler criterion, namely 119 (26.0%) because of E/A <0.7 and 11 because of E/A >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/A ratio 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. Received for publication 15 September 2011; accepted for publication 24 October 2011.
Authors:
Francesca Negri; Carla Sala; Cristiana Valerio; Giuseppe Mancia; Cesare Cuspidi
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension     Volume:  18     ISSN:  1179-1985     ISO Abbreviation:  High Blood Press Cardiovasc Prev     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2012-01-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9421087     Medline TA:  High Blood Press Cardiovasc Prev     Country:  New Zealand    
Other Details:
Languages:  eng     Pagination:  187-93     Citation Subset:  IM    
Affiliation:
Department of Clinical Medicine and Prevention, University of Milano-Bicocca, Milan, Italy.
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