Tissue Doppler Image-Derived Measurements During Isovolumic Contraction Predict Exercise Capacity in Patients With Reduced Left Ventricular Ejection Fraction
Eun Joo Cho, MD, PhD,
Giuseppe Caracciolo, MD,
Bijoy K. Khandheria, MD,
D. Eric Steidley, MD,
Robert Scott, MD,
Walter P. Abhayaratna, MD,
Krishnaswamy Chandrasekaran, MD,
Partho P. Sengupta, MD, DM*
Division of Cardiovascular Diseases, Mayo Clinic, Scottsdale, Arizona
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Figure 1 Measurement of Annular Tissue Velocities
Peak contraction and relaxation velocities were averaged from the lateral and septal corners of mitral valve annulus during isovolumic contraction (IVCa), systolic ejection (Sa), isovolumic relaxation (IVRa), early (Ea), and late (Aa) diastolic phases of the cardiac cycle at a speed of 100 mm/s.
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Figure 2 Annular Velocities and % Predicted Peak VO2 >50%
Correlation between annular tissue Doppler velocity and % predicted peak oxygen consumption (VO2) in patients with left ventricular systolic dysfunction. Abbreviations as in Figure 1.
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Figure 3 Diagnostic Value of Tissue Doppler-Derived Measurements
The receiver-operator characteristic curve analysis of IVCa, Aa, and isovolumic acceleration (IVA) for prediction of % predicted peak volume of oxygen >50% in patients with left ventricular systolic dysfunction. Area under the curve was 0.86, p value was 0.001 for IVCa; area under the curve was 0.82, p value was 0.003 for Aa; and area under the curve was 0.74, p value was 0.026 for IVA. A cutoff value of 3.8 cm/s for IVCa had 88% sensitivity and 72% specificity, while a cutoff value of 5.8 cm/s for Aa had 81% sensitivity and 65% specificity, and 0.96 m/s for IVA had 95% sensitivity and 50% specificity for predicting % predicted volume of oxygen >50%. Abbreviations as in Figure 1.
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