ORGINAL ARTICLE Diagnostic utility of tissue tracking echocardiography for the diagnosis of ischaemic heart disease

Abstract

Introduction: Both the resting electrocardiogram and standard echocardiography have limited value in detecting ischaemic heart disease (IHD) in patients with atypical symptoms or asymptomatic subjects. Tissue tracking (TT) is a novel method based on tissue Doppler echocardiography for the assessment of longitudinal apical myocardial motion. Aim: To assess diagnostic utility of TT mode in the diagnosis of IHD. Methods: The study was performed in a group of 36 patients (aged 58±8 years, 15 males) with good acoustic window, sinus rhythm and normal left ventricular ejection fraction on standard echocardiography who were previously selected for coronary angiography. Systolic displacement of myocardium (TT) was assessed in all patients using apical views (4, 2, and 3-chamber) and 7-colour-coded visualisation expressing various apical displacements of the myocardium during systole. Group IHD(–) consisted of 16 patients with normal coronary angiography or insignificant lesions and group IHD(+) consisted of 20 patients with significant (>70%) coronary lesions. Results: Despite similar prevalence of arterial hypertension and diabetes as well as similar pharmacological treatment patients from the IHD(+) group had a lower TT index (ratio of the sum of regional TT values to the number of analysed segments than the IHD(–) (patients 4.5±0.8 mm vs 5.9±0.9 mm respectively, p <0.001). Conclusions: Resting echocardiography with tissue tracking enables fast, non-invasive and semiquantitative evaluation of left ventricular function. This method of assessment of longitudinal layers of the left ventricle may be useful in the diagnosis of ischaemic heart disease.