Korean Circ J.  2011 Mar;41(3):137-142. 10.4070/kcj.2011.41.3.137.

Determination of Diastolic Dysfunction Cut-Off Value by Tissue Doppler Imaging in Adults 70 Years of Age or Older: A Comparative Analysis of Pulsed-Wave and Color-Coded Tissue Doppler Imaging

• Baek HK
• Park TH
• Park SY
• Kim JH
• Seo JM
• Kim WJ
• Nam YH
• Kim MH
• Kim YD

• KMID: 2225127
• DOI: http://doi.org/10.4070/kcj.2011.41.3.137

Abstract

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 > or =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.

Keyword

Heart failure, diastolic; Echocardiography; Aging

MeSH Terms

Adult
Aged
Aging
Echocardiography
Echocardiography, Doppler
Female
Heart Failure, Diastolic
Humans
Hypertension

Figure

• 

  Fig. 1 Box plots showing distributions of septal and lateral Ea measured by pulsed-wave TDI and color-coded TDI, respectively. Box heights reflect interquartile ranges (IQRs). Vertical capped lines (whiskers) extend to most extreme data points within 1.5 IQRs of boxes. Data beyond 1.5 IQRs from boxes are plotted individually. Ea: early diastolic mitral annulus velocity, TDI: tissue Doppler imaging.

• 

  Fig. 2 Receiver-operator characteristic curve of Ea. The point (●) is the sensitivity and specificity of cut-off value, which is defined by the lower limit of the 95% CI for Ea to detect hypertensive patients who have diastolic dysfunction. TDI: tissue Doppler imaging.

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