Key result
In adults aged 70 years or older, color-coded tissue Doppler imaging yielded significantly lower early diastolic mitral annulus velocities than pulsed-wave imaging, resulting in different diastolic dysfunction cut-off values (septal Ea 5.7 vs 6.1 cm/s).
Cross-Sectional (n=127)
Single-blind
No
Absolute Event Rate: 6.1% vs 6.5%
p-value: p=<0.001
When interpreting diastolic function by tissue Doppler imaging in elderly subjects, different cut-off values should be used depending on whether pulsed-wave or color-coded modalities are utilized.
May require modality-specific Ea thresholds in elderly patients; leaves open whether this refines diastolic dysfunction assessment.
BACKGROUND AND OBJECTIVES: The cut-off value of diastolic dysfunction by tissue Doppler imaging (TDI) is affected by aging and modalities used (pulsed-wave vs. color-coded). The purpose of this study was to investigate the diastolic function of healthy elderly people and to determine the appropriate cut-off value of diastolic dysfunction in elderly individuals. SUBJECTS AND METHODS: Healthy volunteers (n=76) and patients with hypertension (n=51) aged ≥70 years underwent 2-dimensional and Doppler echocardiography. Mitral annulus velocities of TDI were measured at septal and lateral sites using the pulsed-wave and color-coded modalities. The appropriate cut-off value of diastolic dysfunction for healthy elderly individuals was defined as the lower limit of the 95% confidence interval for early diastolic mitral annulus velocity (Ea). RESULTS: The mean septal and lateral Ea were 6.5±1.5 and 8.3±1.7 cm/s, respectively, by pulsed-wave TDI, and 6.1±1.4 and 7.9±1.7 cm/s, respectively, by color-coded TDI. The cut-off values for diastolic dysfunction were as follows: septal and lateral Ea were 6.1 and 7.9 cm/s by pulsed-wave TDI, and 5.7 and 7.5 cm/s by color-coded TDI, respectively. When the group was stratified by gender, Ea was significantly lower in women than men. CONCLUSION: When interpreting diastolic function as measured by TDI in elderly subjects, different cut-off values should be considered based on the TDI modality, annulus site, and gender.
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Baek et al. (2011) conducted a cross-sectional in Diastolic dysfunction (n=127). Color-coded tissue Doppler imaging vs. Pulsed-wave tissue Doppler imaging was evaluated on Mean septal early diastolic mitral annulus velocity (Ea) in healthy elderly subjects (p=<0.001). In adults aged 70 years or older, color-coded tissue Doppler imaging yielded significantly lower early diastolic mitral annulus velocities than pulsed-wave imaging, resulting in different diastolic dysfunction cut-off values (septal Ea 5.7 vs 6.1 cm/s).
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