Tissue Doppler Imaging (TDI) Echocardiography

📌 Tissue Doppler Imaging (TDI): Understanding S′, e′, a′ and the Tei Index

Tissue Doppler Imaging (TDI) is a valuable echocardiographic technique used to assess both systolic and diastolic myocardial function through measurement of mitral annular velocities.

🔹 S′ (Systolic Velocity)

• Represents longitudinal LV systolic contraction.

• Measured during ventricular systole.

• Reduced S′ suggests impaired LV systolic function.

🔹 e′ (Early Diastolic Velocity)

• Reflects active myocardial relaxation.

• A key parameter for assessing LV diastolic function.

• Reduced e′ indicates impaired relaxation and diastolic dysfunction.

🔹 a′ (Late Diastolic Velocity)

• Generated by atrial contraction.

• Becomes more prominent when ventricular relaxation is impaired.

📏 Important Time Intervals

⏱ IVCT (Isovolumic Contraction Time)

• Interval between mitral valve closure and aortic valve opening.

⏱ ET (Ejection Time)

• Duration of ventricular ejection.

⏱ IVRT (Isovolumic Relaxation Time)

• Interval between aortic valve closure and mitral valve opening.

🧮 Myocardial Performance Index (Tei Index)

MPI = (IVCT + IVRT) / ET

✅ Assesses combined systolic and diastolic ventricular performance.

✅ Higher values indicate worse global ventricular function.

✅ Normal LV MPI (TDI-derived) is typically < 0.40.

💡 Clinical Applications

✔ Assessment of LV systolic function

✔ Evaluation of diastolic dysfunction

✔ Estimation of filling pressures using E/e′ ratio

✔ Heart failure evaluation

✔ Cardiomyopathies and ischemic heart disease

✔ Follow-up of valvular heart disease

🎯 Remember:

S′ = Systolic function

e′ = Relaxation

a′ = Atrial contribution

Tei Index = Global ventricular performance

#Echo #Echocardiography #TDI #TissueDoppler #Cardiology #ASEGuidelines #CardiacImaging

Comments

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𝘼𝙣𝙩𝙞𝙘𝙤𝙖𝙜𝙪𝙡𝙖𝙩𝙞𝙤𝙣 𝘼𝙛𝙩𝙚𝙧 𝙎𝙩𝙧𝙤𝙠𝙚 in Patient with AF and acute IS/TIA European Heart Association Guideline recommends: • 1 days after TIA • 3 days after mild stroke • 6 days after moderate stroke • 12 days after severe stroke Early anticoagulation can decrease a risk of recurrent stroke and embolic events but may increase a risk of secondary hemorrhagic transformation of brain infarcts. The 1-3-6-12-day rule is a known consensus with graded increase in delay of anticoagulation between 1 and 12 days after onset of ischemic stroke or transient ischemic attack(TIA), according to neurological severity based on European expert opinions. However, this rule might be somewhat later than currently used in a real-world practical setting.

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