PubMed · 10582449
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D L Brutsaert. 1999. Diastolic heart function and dysfunction.. https://pubmed.ncbi.nlm.nih.gov/10582449/
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Tissue Doppler echocardiography is a variation of conventional Doppler flow imaging. This modality allows quantification of the Doppler shift within the range of myocardial tissue motion. The velocity at a variety of myocardial sites can be determined and distinguished very rapidly by using Doppler techniques. The velocity of moving tissue can be studied with pulsed wave tissue Doppler sampling, which displays the velocity of a selected myocardial region against time, with high temporal resolution. In addition, the velocities can be calculated with time-velocity maps and displayed as color-encoded velocity maps in either an M-mode or 2-dimensional format. This review will focus on the technical aspects and the different methods of tissue Doppler echocardiography for the analysis of regional systolic and diastolic left ventricular function. Whereas pulsed wave tissue Doppler echocardiography allows measurements of velocities of a selected myocardial region, color tissue Doppler gives the best overview of cardiac dynamics because the entire scanned color data are displayed simultaneously. However, there is an increasing need for objective evaluation of tissue Doppler information. Digital images and postprocessing of the data allow for quantitative off-line analysis, and the different approaches and parameters proposed from different centers are discussed.
Left ventricular (LV) diastolic dysfunction has been reported in the subacute and late phase after myocardial infarction and it is becoming increasingly clear that abnormalities of diastolic function during acute myocardial infarction (AMI) have a major role in affecting the prognosis. However, until recent years the study of patients with diastolic dysfunction has suffered from the substantial difficulties inherent in diagnosing, measuring, quantitating and in following it over time. Moreover, the complexity of events encompassed by diastole, which are often difficult to control in the clinical arena, and the lack of data available to guide therapy, have hampered the widespread application of diastology in the clinical setting of AMI. The advent of Doppler echocardiography and its complementary techniques have provided a bedside tool which yields reliable and useful measures of diastolic performance during AMI, placing such an assessment well within the grasp of every clinical echocardiographic laboratory. Determination of the pattern of LV filling by Doppler echocardiography provides important information about LV diastolic function in AMI patients. Clinical data gathered so far demonstrate that Doppler-derived LV filling, specifically the restrictive filling pattern, is a powerful independent predictor of late LV dilation and, most importantly, of cardiac death in patients with AMI and clearly indicate the need for evaluating and monitoring LV diastolic function in these patients. Large scale studies, utilizing simple and easy to measure Doppler indexes of LV filling are needed to assess the efficacy of medical therapy in patients with acute LV diastolic dysfunction during AMI.