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. and Zolgharni, M. and Willson, K. and Cole, G. and Nowbar, A. N. and Dawson, D. and Zielke, S. and Whelan, C. and Newton, J. and Mayet, J. and 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 0195-668X

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Item Type:Article
Item Status:Live Archive

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

Keywords:Echocardiography, Tissue Doppler, Velocity, Calibration, JCNotOpen
Subjects:B Subjects allied to Medicine > B800 Medical Technology
H Engineering > H673 Bioengineering
Divisions:College of Science > School of Computer Science
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ID Code:19617
Deposited On:19 Nov 2015 13:56

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