title: A way to improve the reproducibility of measurements of myocardial velocity gradients.
abstract: BACKGROUND
  A peak negative myocardial velocity gradient (MVG) across the left ventricular wall is an important indicator of diastolic performance. The reproducibility of MVG measurements by color M-Mode tissue Doppler imaging (TDI) is still unsatisfactory, restraining its use in clinical practice. Aim of the study was to improve the reproducibility of measurements of MVG.
  
  
  METHODS
  The peak diastolic MVG of left ventricular posterior wall was determined in 50 consecutive patients by two investigators in two ways: (1) using directly standard anatomic color M-Mode TDI and (2) by the same technique, but guided by a preliminary MVG estimation with pulsed TDI using four measurement sets within the ventricular wall.
  
  
  RESULTS
  The interobserver agreement limits of the combined method [-0.78 s(-1) (95% CI: -0.95 to -0.6 s(-1)) to 0.57 s(-1) (95% CI: 0.4-0.75 s(-1))] were clearly superior to those shown by color M-Mode TDI without B-Mode pre-assessment [-1.35 s(-1) (95% CI: -1.72 to -0.98 s(-1)) to 1.5 s(-1) (95% CI: 1.13-1.87 s(-1))].
  
  
  CONCLUSIONS
  An initial estimation by pulsed TDI is useful to achieve a clinically acceptable reproducibility of MVG measurements.
authors.affiliation: Department of Medicine, University Hospital of Mannheim, Germany. tudor.poerner@med.ma.uni-heidelberg.de
authors.forename: Tudor C
authors.initials: TC
authors.lastname: Poerner
authors.forename: Björn
authors.initials: B
authors.lastname: Goebel
authors.forename: Sisi
authors.initials: S
authors.lastname: Vilardi
authors.forename: Martin
authors.initials: M
authors.lastname: Borggrefe
authors.forename: Karl K
authors.initials: KK
authors.lastname: Haase
mesh_terms: D003971:Diastole / Q000502:physiology; D015150:Echocardiography, Doppler; D006801:Humans; D012044:Regression Analysis; D015203:Reproducibility of Results; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000503:physiopathology*