Role of tissue Doppler imaging in assessing left ventricular diastolic dysfunction severity. Does it hold the same ability?

OBJECTIVE: To validate the diagnostic capability of tissue Doppler imaging in assorting the extent of diastolic dysfunction.

METHODS: In this primary clinical research diagnostic study, we enrolled 70 patients with systemic hypertension presenting with shortness of breath between May 2010 to July 2010 to Salmaniya Medical Complex, Manama, Bahrain. Forty-eight patients satisfied the inclusion criteria. They underwent extensive echocardiographic assessment of their diastolic function with simultaneous NT pro-B-type natriuretic (BNP) assay. The latter being the reference marker of diastolic defragment.

RESULTS: Patients were classified according to the severity of heart failure into 4 classes of New York Heart Association (NYHA) Classification. Twenty-eight (58%) were males and 20 (42%) were females. The tissue Doppler imaging (TDI) maintained a steady positive correlation with both NYHA functional class and the PRO-BNP titre. Correlation coefficient was 0.8 with a p<0.0001. N-terminal pro-B-type natriuretic peptide (NT-proBNP) can be calculated from simplified formula derived from the correlation-pro-B-NP = 93.8 x (E/E')-940.

CONCLUSION: The TDI can estimate the severity of diastolic dysfunction with striking certainty and tremendous clinical utility. Its limitation, however, has to be well addressed.