J Cardiovasc Ultrasound.  2016 Jun;24(2):144-152. 10.4250/jcu.2016.24.2.144.

Normal Echocardiographic Measurements in a Korean Population Study: Part II. Doppler and Tissue Doppler Imaging

• Choi JO
• Shin MS
• Kim MJ
• Jung HO
• Park JR
• Sohn IS
• Kim H
• Park SM
• Yoo NJ
• Choi JH
• Kim HK
• Cho GY
• Lee MR
• Park JS
• Shim CY
• Kim DH
• Shin DH
• Shin GJ
• Shin SH
• Kim KH
• Park JH
• Lee SY
• Kim WS
• Park SW

• KMID: 2308704
• DOI: http://doi.org/10.4250/jcu.2016.24.2.144

Abstract

BACKGROUND
Hemodynamic and functional evaluation with Doppler and tissue Doppler study as a part of comprehensive echocardiography is essential but normal reference values have never been reported from Korean normal population especially according to age and sex.
METHODS
Using Normal echOcaRdiographic Measurements in a KoreAn popuLation study subjects, we obtained normal reference values for Doppler and tissue Doppler echocardiography including tricuspid annular velocities according to current guidelines and compared values according to gender and age groups.
RESULTS
Mitral early diastolic (E) and late diastolic (A) velocity as well as E/A ratio were significantly higher in women compared to those in men. Conversely, mitral peak systolic and late diastolic annular velocity in both septal and lateral mitral annulus were significantly lower in women compared to those in men. However, there were no significant differences in both septal and lateral mitral early diastolic annular (e') velocity between men and women. In both men and women, mitral E velocity and its deceleration time as well as both E/A and E/e' ratio considerably increased with age. There were no significant differences in tricuspid inflow velocities and tricuspid lateral annular velocities between men and women except e' velocity, which was significantly higher in women compared to that in men. However, changes in both tricuspid inflow and lateral annular velocities according to age were similar to those in mitral velocities.
CONCLUSION
Since there were significant differences in Doppler and tissue Doppler echocardiographic variables between men and women and changes according to age were even more considerable in both gender groups, normal Doppler echocardiographic values should be differentially applied based on age and sex.

Keyword

Transthoracic echocardiography; Doppler; Tissue Doppler; Normal population; Reference value

MeSH Terms

Deceleration
Echocardiography*
Echocardiography, Doppler
Female
Hemodynamics
Humans
Male
Reference Values

Reference

1. Nagueh SF, Appleton CP, Gillebert TC, Marino PN, Oh JK, Smiseth OA, Waggoner AD, Flachskampf FA, Pellikka PA, Evangelisa A. Recommendations for the evaluation of left ventricular diastolic function by echocardiography. Eur J Echocardiogr. 2009; 10:165–193.

2. Writing Committee Members. Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE Jr, Drazner MH, Fonarow GC, Geraci SA, Horwich T, Januzzi JL, Johnson MR, Kasper EK, Levy WC, Masoudi FA, McBride PE, McMurray JJ, Mitchell JE, Peterson PN, Riegel B, Sam F, Stevenson LW, Tang WH, Tsai EJ, Wilkoff BL. American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation. 2013; 128:e240–e327.

3. Caballero L, Kou S, Dulgheru R, Gonjilashvili N, Athanassopoulos GD, Barone D, Baroni M, Cardim N, Gomez de Diego JJ, Oliva MJ, Hagendorff A, Hristova K, Lopez T, Magne J, Martinez C, de la Morena G, Popescu BA, Penicka M, Ozyigit T, Rodrigo Carbonero JD, Salustri A, Van De Veire N, Von Bardeleben RS, Vinereanu D, Voigt JU, Zamorano JL, Bernard A, Donal E, Lang RM, Badano LP, Lancellotti P. Echocardiographic reference ranges for normal cardiac Doppler data: results from the NORRE Study. Eur Heart J Cardiovasc Imaging. 2015; 16:1031–1041.

4. Daimon M, Watanabe H, Abe Y, Hirata K, Hozumi T, Ishii K, Ito H, Iwakura K, Izumi C, Matsuzaki M, Minagoe S, Abe H, Murata K, Nakatani S, Negishi K, Yoshida K, Tanabe K, Tanaka N, Tokai K, Yoshikawa J. JAMP Study Investigators. Normal values of echocardiographic parameters in relation to age in a healthy Japanese population: the JAMP study. Circ J. 2008; 72:1859–1866.

5. Okura H, Takada Y, Yamabe A, Kubo T, Asawa K, Ozaki T, Yamagishi H, Toda I, Yoshiyama M, Yoshikawa J, Yoshida K. Age- and gender-specific changes in the left ventricular relaxation: a Doppler echocardiographic study in healthy individuals. Circ Cardiovasc Imaging. 2009; 2:41–46.

6. Dalen H, Thorstensen A, Vatten LJ, Aase SA, Stoylen A. Reference values and distribution of conventional echocardiographic Doppler measures and longitudinal tissue Doppler velocities in a population free from cardiovascular disease. Circ Cardiovasc Imaging. 2010; 3:614–622.

7. Park SW. Multicenter trial for estimation of normal values of echocardiographic indices in Korea. Korean Circ J. 2000; 30:373–382.

8. Choi JO, Shin MS, Kim MJ, Jung HO, Park JR, Sohn IS, Kim H, Park SM, Yoo NJ, Choi JH, Kim HK, Cho GY, Lee MR, Park JS, Shim CY, Kim DH, Shin DH, Shin GJ, Shin SH, Kim KH, Park JH, Lee SY, Kim WS, Park SW. Normal echocardiographic measurements in a Korean population study: part I. Cardiac chamber and great artery evaluation. J Cardiovasc Ultrasound. 2015; 23:158–172.

9. Owan TE, Hodge DO, Herges RM, Jacobsen SJ, Roger VL, Redfield MM. Trends in prevalence and outcome of heart failure with preserved ejection fraction. N Engl J Med. 2006; 355:251–259.

10. Nagueh SF, Appleton CP, Gillebert TC, Marino PN, Oh JK, Smiseth OA, Waggoner AD, Flachskampf FA, Pellikka PA, Evangelista A. Recommendations for the evaluation of left ventricular diastolic function by echocardiography. J Am Soc Echocardiogr. 2009; 22:107–133.

11. Kou S, Caballero L, Dulgheru R, Voilliot D, De Sousa C, Kacharava G, Athanassopoulos GD, Barone D, Baroni M, Cardim N, Gomez De Diego JJ, Hagendorff A, Henri C, Hristova K, Lopez T, Magne J, De La Morena G, Popescu BA, Penicka M, Ozyigit T, Rodrigo Carbonero JD, Salustri A, Van De Veire N, Von Bardeleben RS, Vinereanu D, Voigt JU, Zamorano JL, Donal E, Lang RM, Badano LP, Lancellotti P. Echocardiographic reference ranges for normal cardiac chamber size: results from the NORRE study. Eur Heart J Cardiovasc Imaging. 2014; 15:680–690.

12. Galiuto L, Ignone G, DeMaria AN. Contraction and relaxation velocities of the normal left ventricle using pulsed-wave tissue Doppler echocardiography. Am J Cardiol. 1998; 81:609–614.

13. Choi JH, Choi JO, Ryu DR, Lee SC, Park SW, Choe YH, Oh JK. Mitral and tricuspid annular velocities in constrictive pericarditis and restrictive cardiomyopathy: correlation with pericardial thickness on computed tomography. JACC Cardiovasc Imaging. 2011; 4:567–575.

14. Tabata T, Thomas JD, Klein AL. Pulmonary venous flow by doppler echocardiography: revisited 12 years later. J Am Coll Cardiol. 2003; 41:1243–1250.

15. Klein AL, Burstow DJ, Tajik AJ, Zachariah PK, Bailey KR, Seward JB. Effects of age on left ventricular dimensions and filling dynamics in 117 normal persons. Mayo Clin Proc. 1994; 69:212–224.