Tissue Doppler Flashcards

1
Q

Tissue Doppler Imaging

A
  • Mitral / Tricuspid annular velocities
  • high amplitude, low velocity signals (low pass filter on)
  • systolic (s’) , early (e’) , late (a’)
  • angle dependent (keep < 20º)
  • average ≥ 3 cardiac cycles
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2
Q

Diastolic Function

A
• e’ < 8 cm/s = bad
• lateral e’ > septal e’
- exception: constrictive pericarditis (lateral < septal) annular reversus 
• e’ > 10 cm/s = good
• a’ < 10 cm/s = good
• e’ / a’ < 1 = bad
• s’ > 8 = good
• s’ < 5 = bad
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3
Q

TDI : detection of ischemia

A
  • s’ , e’ , e’/a’ decrease
  • TDI changes occur faster than reduction of systolic excursion & wall motion changes
  • post systolic shortening
  • isovolumic contraction velocity decreases
  • prolongation of the Q-to-peak-s’ time interval
  • ECG-Q-to-e’ onset > ECG-Q-to-TMF-E onset
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4
Q

TDI limitations

A
  • mitral annular disease / tethering
  • time intervals require regular rhythm & stable HR
  • regional
  • normal patients —> preload dependent
  • angle dependent
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5
Q

Tamponade vs Constrictive Pericarditis

A

• Transmitral Inflow

  • RICM : e’ < 8 cm/s
  • CP : e’ > 10 cm/s ; lateral e’ < septal e’
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6
Q

TDI for diastology

A
  • e’ > 10 cm/s —> done.
  • e’ < 8 - 10 —> look at other stuff ….
  • E/e’ > 13 —> elevated LAP
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7
Q

TDI for MPI

A

• measures both systolic and diastolic function
• lower number = better
•MPI = (IVCT + IVRT) / ET
- normal = 0.4
- elevated MPI = abnormal systolic & diastolic function

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8
Q

Right Heart

A

• RV s’ < 10 cm/s = low in young healthy people
• IVA = 1.4 +/- 0.5 m/s^2 (wide confidence levels = not very reliable)
• MPI = (IVCT + IVRT) / ET
- (TR jet duration - ET) / ET
- relatively independent of HR, preload, and afterload
- measures both systolic and diastolic function
- > 0.5 predictive of HD instability and mortality after valve surgery
•Strain Rate = (V2 - V1) / x
- not used often perioperative but useful in detecting early onset of ischemia prior to detection of WMA

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