Determination of Diastolic Dysfunction Cut-Off Value by Tissue Doppler Imaging in Adults 70 Years of Age or Older: A Comparative Analysis of Pulsed-Wave and Color-Coded Tissue Doppler Imaging

BACKGROUND AND OBJECTIVES The cut-off value of diastolic dysfunction by tissue Doppler imaging (TDI) is affected by aging and modalities used (pulsed-wave vs. color-coded). The purpose of this study was to investigate the diastolic function of healthy elderly people and to determine the appropriate cut-off value of diastolic dysfunction in elderly individuals. SUBJECTS AND METHODS Healthy volunteers (n=76) and patients with hypertension (n=51) aged ≥70 years underwent 2-dimensional and Doppler echocardiography. Mitral annulus velocities of TDI were measured at septal and lateral sites using the pulsed-wave and color-coded modalities. The appropriate cut-off value of diastolic dysfunction for healthy elderly individuals was defined as the lower limit of the 95% confidence interval for early diastolic mitral annulus velocity (Ea). RESULTS The mean septal and lateral Ea were 6.5±1.5 and 8.3±1.7 cm/s, respectively, by pulsed-wave TDI, and 6.1±1.4 and 7.9±1.7 cm/s, respectively, by color-coded TDI. The cut-off values for diastolic dysfunction were as follows: septal and lateral Ea were 6.1 and 7.9 cm/s by pulsed-wave TDI, and 5.7 and 7.5 cm/s by color-coded TDI, respectively. When the group was stratified by gender, Ea was significantly lower in women than men. CONCLUSION When interpreting diastolic function as measured by TDI in elderly subjects, different cut-off values should be considered based on the TDI modality, annulus site, and gender.