Quantitative tissue Doppler in comparison with two-dimensional and doppler echocardiographic indices in normal subjects

To assess normal values of left ventricular wall motion velocities with respect to sequential phases of the cardiac cycle 95 normal subjects (mean age 34±12 years) were examined using a recently developed method based on the computer software TDI-LaborR enabling a variable time and space related measurement of regional wall velocity from tissue Doppler (TD) images. The study population consisted of three age groups: 16–29 years (group 1, n=34 (36%)), 30–49 years (group 2, n=45 (49%)), >50 years (group 3, n=16 (17%)). Using TD M-mode of the left ventricular posterior wall the mean subendocardial and subepicardial velocity as well as the transmural myocardial velocity were determined for the rapid, slow and atrial filling phases as well as the systole. In addition, standard mitral inflow parameters-E and A velocities were determined by pulsed Doppler echocardiography. The left parasternal window was used. The subendocardial rapid filling and atrial filling myocardial velocity were found to be age significantly dependent. The myocardial rapid filling were correlated to early diastolic mitral inflow velocity and to the ratio of early and atrial flow velocities (r ranges from 0.23 to 0.36, P<0.01). We conclude that aging is accompanied by an increase of atrial filling compensating a reduced myocardial relaxation already before 50 years. Whereas mitral inflow velocities reflect diastolic function indirectly, it is directly indicated by TD myocardial velocity parameters.