Non-Invasive Assessment of Left Focus Ventricular Diastolic Function: On Tissue Doppler Imaging and B-Type Natriuretic Peptide

Tissue Doppler (TD) imaging is a novel echocardiographic technique that directly measures myocardial velocities. Systolic TD measurements assess left and right ventricular (RV) myocardial contractile function. Diastolic TD values reflect myocardial relaxation, and in combination with conventional Doppler measurements, ratios (E/Ea) have been developed to non-invasively estimate left ventricular (LV) filling pressures. These TD-derived ratios have been helpful in diagnosing elevated LV filling pressures, clinical congestive heart failure (CHF), and the prognosis of patients with cardiac disease and CHF. B-type natriuretic peptide reflects myocardial stretch and has been correlated to LV filling pressures and cardiac morphological abnormalities (depressed EF, RV dysfunction). TD echocardiography is being used in an ever-widening group of patients to assess LV diastolic function, and researchers are actively investigating its correlation and comparison with B-type natriuretic peptide.