Abstract 1853: Have tissue Doppler Parameters Improved on Conventional Echocardiographic Parameters for Sequential Evaluation of LV Function?
Background: Sequential 2D echos (2DE) are often performed to assess LV function over time, but the value of sequential testing is unclear. Conventional measures (eg. EF) have significant test-retest variability, but this is less defined with newer measures (eg. tissue velocity [Em], E/E’ and LA size). We sought the variation between measures of LV function in pts referred for sequential 2DE.
Methods: Two sequential 2DE were performed in an unselected group of 357 pts, with measurement of change in LA area, LVEF, Em and E/Em. Pts were classified as clinically stable (n=160) or unstable (n=197) based on their clinical progress. Differences in change of each parameter were compared between stable and unstable groups using a t-test. The degree of variance between measurement of Δ LVEF and each new parameter was assessed with an F-test after mean-correction to make measures comparable.
Results: Change in Em was the only measurement that had a significant mean difference between stable and unstable pts (Table⇓). In stable pts, the coefficient of variation (CV) of ΔEm (83%, F-test p<0.01 vs EF) and ΔLA (81%) were less than ΔEF (102%) and ΔE/E’ (105%). Stable pts with either heart failure or ischemic heart disease had the least degree of variance between measures.
Conclusions: ΔEm shows the greatest difference between stable and unstable pts and its CV suggests less variation than the other parameters in stable pts. However, the variance of all measures was high, even in stable pts. More robust markers of LV function are needed for sequential follow-up.