The Aortic, Mitral and Tricuspid Annuli and Their Velocities: A Comparative Echocardiographic Study

Objectives: The velocities at the mitral (MA) and tricuspid (TA) annuli have earlier been studied by using both colour coded tissue Doppler imaging (TVI) and pulsed wave tissue Doppler imaging (PW DTI) but the velocities at the aortic annulus (AA) and the both other annuli have only been examined using TVI and not PW DTI in one study before. Therefore the aim of the present study was to compare the systolic (s´)-, early (e´)- and late (a´) diastolic velocities at the three different annuli with both methods. Design: 24 healthy subjects were examined by echocardiography and the velocities at the annuli were measured using PW DTI and TVI. Results: For all the velocities there was a statistically significant difference (p<0.001) between the two methods, the velocities obtained by PW DTI being higher. However some heterogeneity of the mean velocity differences between methods were noted by annuli and site, but PW DTI always showing highest mean levels. There were also statistically significant velocity differences between different sites and annuli. There was a good-very good intra- and inter observer reproducibility of measuring the velocities at the aortic annulus. Conclusion: The velocities were significantly higher using PW DTI than using TVI at the different annuli, probably mainly due to the way the respective method is measuring the velocities. In addition there was shown some heterogeneity of the mean velocity differences and statistically significant velocity differences between different sites and annuli. The both methods need different reference values and could not be used interchangeably. The findings could be of importance in special cases where the interaction between the three different annuli and sites is of importance, but including the velocities at all the three different sites in a clinical routine echocardiographic examination will often not be necessary.