title: Concordance between M-mode, pulsed Tissue Doppler, and colour Tissue Doppler in the assessment of mitral annulus systolic excursion in normal subjects.
abstract: OBJECTIVE
  M-mode left atrioventricular plane displacement (AVPD) correlates with Tissue Doppler (TD) peak systolic annular velocity in healthy individuals. This approach is biased by several interacting factors related to the structural complexity of mitral annulus physiology, including the different dimensional values of measures, the confounding effect of isovolumic motions, and the spectral thickness of pulsed TD envelope. We sought to analyze the effective concordance between techniques in the assessment of systolic annular excursion.
  
  
  RESULTS
  In 92 healthy subjects (age 60.5 +/- 18.6, 43.5% women), systolic AVPD was measured after exclusion of isovolumic components using three techniques: (i) M-mode; (ii) temporal integration of pulsed TD systolic wave; and (iii) colour TD-derived tissue tracking. Close correlations of M-mode AVPD with pulsed TD velocity-time integral (VTI) (R = 0.90, P < 0.0001) and colour TD AVPD (R = 0.86, P < 0.0001) were found. However, M-mode AVPD underestimated pulsed TD VTI (mean error -5.1 +/- 1.7 mm) and overestimated colour TD AVPD (mean error 3.4 +/- 1.3 mm). The concordance between M-mode and pulsed TD increased after adjustment for spectral dispersion of pulsed TD instantaneous velocities (mean error 0.1 +/- 1.1 mm).
  
  
  CONCLUSIONS
  Despite strict correlations exist between M-mode and TD in the assessment of mitral annulus systolic excursion, the effective concordance between techniques is sub-optimal.
authors.affiliation: Cardiology Operative Unit, S. Andrea Hospital, via Veneto 197, 19100 La Spezia, Italy. pcballo@tin.it
authors.forename: Piercarlo
authors.initials: P
authors.lastname: Ballo
authors.forename: Arianna
authors.initials: A
authors.lastname: Bocelli
authors.forename: Andrea
authors.initials: A
authors.lastname: Motto
authors.forename: Sergio
authors.initials: S
authors.lastname: Mondillo
mesh_terms: D000368:Aged; D018618:Echocardiography, Doppler, Color; D018619:Echocardiography, Doppler, Pulsed; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016277:Ventricular Function, Left