Longitudinal ventricular function: Normal values of atrioventricular annular and myocardial velocities measured with quantitative two-dimensional color Doppler tissue imaging

Objective: Quantitative 2-dimensional color Doppler tissue imaging is a new method to reveal impairment of left ventricular (LV) and right ventricular (RV) longitudinal function, which is a potential marker of early myocardial disease. The aim of this study was to obtain normal values for atrioventricular annular and regional myocardial velocities using this method. Methods. A total of 123 healthy patients (age range: 22 to 89 years) underwent echocardiography including color Doppler tissue imaging using a scanner (Vivid 5, GE Vingmed, Horten, Norway) with post-processing analysis (Echopac 6.3, GE Vingmed). Regional myocardial velocities were measured at 12 LV segments in 3 apical views and 2 segments of the free RV wall. Mitral annular velocities from 6 sites, and tricuspid annular velocities at its lateral site, were also assessed. At each site, systolic (S-m), early diastolic (E-m), and late diastolic (A(m)) velocities were measured, and the E-m/A(m) ratio was calculated. Results. Patients were classified into 4 groups aged 20 to 39, 40 to 59, 60 to 79, and greater than or equal to80 years. Mitral annular velocity and regional LV myocardial S-m and E-m progressively decreased with age. A(m), whereas low in the youngest age group, increased significantly in patients more than 40 years of age. The E-m/A(m) ratio gradually declined with aging. There were no differences between age groups in S. measured at the tricuspid annulus and free RV wall, but the pattern of age-related changes of diastolic velocities and E-m/A(m) ratio was the same as in the LV. Slight but significant sex-related differences were observed in middle-aged groups. The intraobserver and interobserver reproducibility was highest for atrioventricular annular velocities. Conclusions. A progressive decrease in S-m reveals a decline in longitudinal systolic LV function with age, whereas systolic RV function remains unaffected. Atrioventricular annular velocity and regional E-m decrease with aging in both ventricles, suggesting a deterioration in the diastolic properties of the myocardium, whereas A(m) increases from middle age implying a compensatory augmentation of atrial function. The study results can be used as reference data for the quantitative assessment of longitudinal LV and RV function in patients with cardiac disease.