Abstract 12879: Concordance and Reproducibility between M-mode, Tissue Doppler Imaging and Two-Dimensional Strain Imaging in the Assessment of Mitral Annular Displacement and Velocity in Patients with Various Heart Conditions

Abstract

Introduction: Mitral annular (MA) displacement reflects longitudinal left ventricular (LV) deformation and systolic velocity measurements reflect the rate of contraction. These are important parameters in the determination of LV function and are valuable in the diagnosis and prognosis of cardiac disease. Two-dimensional strain imaging (2DSI), colour tissue Doppler imaging (TDI) and motion-mode (M-mode) echocardiography can all be used to determine both MA displacement and systolic tissue velocity.

Aim: To test the correlation and reproducibility between M-mode, TDI and 2DSI when measuring MA displacement and systolic tissue velocity.

Methods: Using GE Healthcare Vivid E7 and 9 and Echopac BT11 software, MA displacement and velocity measurements by 2DSI, TDI and M-mode determined in the septal and lateral walls in the apical 4-chamber view were assessed in 50 control subjects and in 168 patients with various cardiac anomalies known to affect longitudinal displacement such as heart failure (n=50), mitral regurgitation (n=37), LV hypertrophy (n=50) and LV dilation (n=31). Intraobserver variability and interobserver variability was tested using the Bland-Altman method in 125 patients and 50 patients, respectively.

Results: MA displacement: 2DSI has a larger variability compared to TDI and M-mode. 2DSI overestimates MA displacement compared to TDI and M-mode. Velocity: There is no clear difference in variability between TDI and 2DSI when compared to M-mode. Both TDI and 2DSI overestimate rate of contraction compared to M-mode. Intraobserver and interobserver variability for both measurements was low and the largest variability was seen in 2DSI compared to M-mode and TDI (see table).

Conclusions: When measuring MA displacement, 2DSI is more inconsistent than TDI and M-mode. When measuring velocity, both 2DSI and TDI are more inconsistent than M-mode. 2DSI has the greatest observer variability. None of the measurement techniques are interchangeable.