Guidance for accurate and consistent tissue Doppler velocity measurement: comparison of echocardiographic methods using a simple vendor-independent method for local validation

Dhutia, N. M., Zolgharni, Massoud ORCID: 0000-0003-0904-2904, Willson, K., Cole, G., Nowbar, A. N., Dawson, D., Zielke, S., Whelan, C., Newton, J., Mayet, J., Manisty, C. H. and Francis, D. P. (2014) Guidance for accurate and consistent tissue Doppler velocity measurement: comparison of echocardiographic methods using a simple vendor-independent method for local validation. European Heart Journal - Cardiovascular Imaging, 15 (7). pp. 817-827. ISSN 2047-2404

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Abstract

Background
Variability has been described between different echo machines and different modalities when measuring tissue velocities. We assessed the consistency of tissue velocity measurements across different modalities and different manufacturers in an in vitro model and in patients. Furthermore, we present freely available software tools to repeat these evaluations.

Methods and results
We constructed a simple setup to generate reproducible motion and used it to compare velocities measured using three echocardiographic modalities: M-mode, speckle tracking, and tissue Doppler, with a straightforward, non-ultrasound, optical gold standard. In the clinical phase, 25 patients underwent M-mode, speckle tracking, and tissue Doppler measurements of s′, e′, and a′ velocities.

In vitro, the M-mode and speckle tracking velocities agreed with optical assessment. Of the three possible tissue Doppler measurement conventions (outer, middle, and inner edge) only the middle agreed with optical assessment (discrepancy −0.20 (95% CI −0.44 to 0.03) cm/s, P = 0.11, outer +5.19 (4.65 to 5.73) cm/s, P < 0.0001, inner −6.26 (−6.87 to −5.65) cm/s, P < 0.0001). A similar pattern occurred across all four studied manufacturers. M-mode was therefore chosen as the in vivo gold standard.

Clinical measurements of s′ velocities by speckle tracking and the middle line of the tissue Doppler showed concordance with M-mode, while the outer line overestimated significantly (+1.27(0.96 to 1.59) cm/s, P < 0.0001) and the inner line underestimated (−1.82 (−2.11 to −1.52) cm/s, P < 0.0001).

Conclusions
Echocardiographic velocity measurements can be more consistent than previously suspected. The statistically modal velocity, found at the centre of the spectral pulsed wave tissue Doppler envelope, most closely represents true tissue velocity. This article includes downloadable, vendor-independent software enabling calibration of echocardiographic machines using a simple, inexpensive in vitro setup.

Item Type: Article
Additional Information: This is a pre-copyedited, author-produced version of an article accepted for publication in European Heart Journal - Cardiovascular Imaging following peer review. The version of record Niti M. Dhutia, Massoud Zolgharni, Keith Willson, Graham Cole, Alexandra N. Nowbar, David Dawson, Sayeh Zielke, Carol Whelan, Jim Newton, Jamil Mayet, Charlotte H. Manisty, Darrel P. Francis; Guidance for accurate and consistent tissue Doppler velocity measurement: comparison of echocardiographic methods using a simple vendor-independent method for local validation, European Heart Journal - Cardiovascular Imaging, Volume 15, Issue 7, 1 July 2014, Pages 817–827, is available online at: https://doi.org/10.1093/ehjci/jeu040
Uncontrolled Keywords: Echocardiography, Tissue Doppler, Velocity, Calibration
Subjects: Computing
Medicine and health
Related URLs:
Depositing User: Massoud Zolgharni
Date Deposited: 11 Dec 2018 17:11
Last Modified: 11 Dec 2018 17:11
URI: http://repository.uwl.ac.uk/id/eprint/5650

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