Characteristics of Mitral and Tricuspid Annular Velocities Determined by Pulsed Wave Doppler Tissue Imaging in Healthy Subjects

doi:10.1053/je.1999.v12.a99246

Journal of the American Society of Echocardiography

Volume 12, Issue 8, August 1999, Pages 618-628

https://doi.org/10.1053/je.1999.v12.a99246 Get rights and content

Abstract

Assessment of myocardial velocities by Doppler tissue imaging is gaining in importance. However, generally accepted reference values are still missing. In this study we examined 62 consecutive healthy subjects (mean age 46, range 22-82 years) by pulsed wave Doppler tissue imaging to characterize the systolic and diastolic velocity profiles of the left and right ventricles. The subjects were divided into 3 different age-groups: group I, younger than 40 years; group II, 40 to 59 years; and group III, 60 years and older. Recordings were made along the long axis in the apical 4- and 2-chamber views by using 4 sites (septal, anterior, lateral, and inferior) at the mitral annulus and 1 site at the tricuspid annulus. Systolic mitral annular velocity (10.3 ± 1.4 cm/s) correlated strongly with global left ventricular function determined by M-mode echocardiographic mitral annular displacement (r = 0.70, P <.001). The systolic velocity was significantly lower in group III than in group I (9.6 vs 10.8 cm/s, P <.01). A relatively weak, but significant, correlation was found between systolic velocity and the age of the subjects (r = –0.43, P <.001). Mitral annular early diastolic velocity was also lower in group III compared with group I (11.3 vs 17.7 cm/s, P <.001), with a strong correlation with age (r = –0.81, P <.001) and other conventional Doppler diastolic parameters. Both the systolic and early diastolic mitral annular velocities at the septum were lower than at other left ventricular sites. Tricuspid annular systolic velocity (15.2 ± 1.9 cm/s) was higher than mitral annular systolic velocity (P <.001). Unlike mitral annular velocity, systolic tricuspid annular velocity was not correlated with age. However, the diastolic tricuspid annular velocities correlated well with transtricuspid Doppler diastolic parameters. The method of recording the annular velocities was feasible in all subjects, simple and highly reproducible. (J Am Soc Echocardiogr 1999;12:618-28.)

Section snippets

METHODS

The study protocol was approved by the local ethical committee.

RESULTS

Table 1 shows basic and echocardiographic parameters for the total population and for different age-groups of population.

. Basic clinical and echocardiographic parameters (results expressed as mean ± SD)

Empty Cell	All subjects (n = 62)	Group I (n = 23)	Group II (n = 21)	Group III (n = 18)
Age (y)	46 ± 15	31 ± 5	46 ± 5	66 ± 5
Men/women	40/22	13/10	16/5	11/7
Heart rate (bpm)	67 ± 9	66 ± 7	67 ± 9	67 ± 10
LVED (mm)	47 ± 4	48 ± 3	48 ± 3	46 ± 4
Left atrial dimension (mm)	34 ± 3	33 ± 4	34 ± 3	34 ± 3
Systolic MAM (mm)	15 ± 2	16 ± 1.3	15 ± 2	14 ±

DISCUSSION

The recording of myocardial velocities with the Doppler technique is not a new concept. The first report dealing with myocardial motion was published by Isaaz et al¹⁴ in 1989, at which time a pulsed Doppler single-sample volume technique was used. The technique has been developed further. Both pulsed wave and color-encoded DTI techniques have emerged as valuable additions to the conventional Doppler echocardiography technique. The velocity image information obtained by DTI is less affected by

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^*: From the Cardiology Section, Department of Medicine, Karolinska Institute at South Hospital (Södersjukhuset), Stockholm, Sweden.

^**: Reprint requests: Mahbubul Alam, MD, Cardiology Section, Södersjukhuset, S-118 83 Stockholm, Sweden. E-mail: [email protected].

^*: 0894-7317/99 $8.00 + 0 27/1/99246

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Characteristics of Mitral and Tricuspid Annular Velocities Determined by Pulsed Wave Doppler Tissue Imaging in Healthy Subjects*,**,*

Abstract

Section snippets

METHODS

RESULTS

DISCUSSION

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