Tissue Doppler imaging

Notabartolo D, Merlino JD, Smith AL, et al. Usefulness of the peak velocity difference by tissue Doppler imaging technique as an effective predictor of response to cardiac resynchronization therapy. Am. J. Cardiol. 2004 94 817-20. 

Sogaard P, Egeblad H, Kim WY, et al. Tissue Doppler imaging predicts improved systolic performance and reversed left ventricular remodeling during long-term cardiac resynchronization therapy. J. Am. Coll. Cardiol. 2002 40 723-30. 

AF atrial fibrillation CHF congestive heart failure ICD implantable cardioverter defibrillator LBBB left bundle branch block LVEDD left ventricular end diastolic dimension LVEF left ventricular ejection fraction 6MHWD 6-minute hall walk distance NSR normal sinus rhythm QoL quality of life TDI tissue Doppler imaging. 

Sogaard P, Egeblad H, Pedersen AK, et al. Sequential versus simultaneous biventricular resynchronization for severe heart failure evaluation by tissue Doppler imaging. Circulation 2002 106 2078-84. 

Tissue Doppler imaging (TDI) which is a feature in some of the newer echo machines is a promising approach to assess dyssynchrony. It measures the time to peak systolic velocity (from the onset of QRS complex) in different segments of the LV and the delay between them is used as a marker of LV dyssynchrony (Fig. 11.6). These measurements can be obtained by pulsed-wave TDI or color-coded TDI that requires postprocessing. Initial studies used... 

Fig. 11.7 Lack of conelation between QRS duration and LV dyssynchrony measured as septal to lateral wall delay using echocardiographic tissue Doppler imaging. (Reproduced with permission from Sleeker GB, Schalij Ml, Molhoek SG, et al. J Cardiovasc Electrophysiol 2004 15 544—9.)...

Fig. 11.8 Stepwise algorithm for management of heart failure patients who are nonresponders to CRT. AV = atrioventricular CXR = chest X-ray EKG = electrocardiogram Htx = heart transplant LV = left ventricular LVAD = left ventricular assist device MR = mitral regurgitation RV = right ventricular VV = interventricular. Cardiac ischemia is evaluated in patients with ischemic cardiomyopathy. Evidence of dyssynchrony includes septal to posterior wall motion delay > 130ms, intraventricular mechanical delay >40ms, and tissue Doppler imaging > 65 ms. (Reproduced witih permission from Aranda JM, Woo GW, Schofield RS, et al. J Am Coll Cardiol 2005 46 2193-8.)...

Penicka M, Bartunek J, De Bruyne B, Vanderheyden M, Goethals M, De Zutter M, Brugada P, Geelen P. Improvement of left ventricular function after cardiac resynchronization therapy is predicted by tissue Doppler imaging echocardiography. Circulation 2004 109 978-83. 

He, A.J., Zheng, C.Q., Wang, T.F., Li, D.Y., Yin, L.X., Zheng Y. 2005. Dynamic three-dimensional reconstruction of tissue Doppler ultrasound heart images. Journal of Biomedicine Engineering 22(3) 570-574. (in Chinese). 

Fig. 17.1. Penile cellulitis. Axial colour Doppler image showing thickening and hypervascularity of the soft tissues surrounding the corpora cavernosa...

Fig. 19.5a,b. Sonography in haemolytic uremic syndrome (HUS), a Severe thickening of the howel wall caused by severe E. coli enteritis (extended view sonography with tissue harmonic imaging), b Alteration of renal parenchymal echogenicity in HUS, with duplex Doppler sonography showing elevated RI (RI = 0,82) due to reduced diastolic flow velocity and increased renal vascular resistance... 

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