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Comparative Study between Tissue Doppler Imaging & Radionuclide Scintigraphy
Figure 12: Tissue Doppler imaging = Sm 12.8 cm/s, IVRT = 33 ms, IVCT = 54 ms, MPI = 0.4,(EJ = 220), SmVTI = 2.2 cm,
Em/Am = 0.8 (pt. No. 20).
Figure 13: Tissue Doppler imaging = Sm 11.7 cm/s, IVCT = 75 ms, IVRT = 93 ms, ET = 177 ms, MPI = 0.9, SmVTI = 1.7,
Em/Am = 0.3 (pt. No. 26).
Discussion
Evaluation of ventricular performance is often
of paramount importance in ICU. Accurate and
timely assessment of systolic ventricular function
should be an integral part of medical management
of the hemodynamically unstable critically ill
patients [11].
Right ventricular dysfunction is common, and
its role in critically ill pts is underestimated [12].
Additionally in the critical care setting, the RV
function is also altered by increasing RV after load
including high levels of positive end-expiratory
pressure or increased pulmonary vascular resistance
[13].
For early diagnosis, electrocardiography and
two dimensional echocardiography [159,160] are
used. However, it is difficult to assess both RV
anatomy and function with reliable conventional
echocardiographic examination because of its complex
structure.
32
Tissue Doppler imaging (TDI) has been evolved
as a new technique that enables myocardial velocities
to be detected and makes the quantitative
assessment of the systolic and diastolic movements
of myocardial walls possible [16,17]. TDI has been
considered to be a technique that leads to assessment
of the RV function [18]. As determined from
the position of the RV tricuspid annulus by TDI,
myocardial velocities and the myocardial performance
index (MPI), which are new parameters in
assessing left ventricular function [19], can also
give information about RV function.
Despite RV function is less often measured than
LV function it has been shown to hold clinical
diagnostic and prognostic importance in many
disorders [20-24]. Owing to its accuracy, First Pass
Radionuclear Angiography has become a non invasive
standard reference for RVEF, and has often
been performed in concern with other measurements
of RV function as a calibration method
[25,26].