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Open Access Highly Accessed Review

Tissue Doppler imaging for diagnosis of coronary artery disease: a systematic review and meta-analysis

Rajender Agarwal1*, Priyanka Gosain1, James N Kirkpatrick2, Tareq Alyousef3, Rami Doukky4, Gurpreet Singh1 and Craig A Umscheid5678

Author Affiliations

1 Department of Medicine, John H. Stroger Jr. Hospital of Cook County, Chicago, IL, USA

2 Cardiovascular Division, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA

3 Division of Cardiology, John H. Stroger Jr. Hospital of Cook County, Chicago, IL, USA

4 Section of Cardiology, Rush University Medical Center, Chicago, IL, USA

5 Division of General Internal Medicine, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA

6 Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA

7 Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA

8 Center for Evidence-based Practice, University of Pennsylvania Health System, Philadelphia, PA, USA

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Cardiovascular Ultrasound 2012, 10:47  doi:10.1186/1476-7120-10-47

Published: 30 November 2012

Abstract

Global and regional left ventricular (LV) systolic dysfunction is a marker of coronary artery disease (CAD), which is conventionally assessed using two-dimensional echocardiography. Tissue Doppler imaging (TDI) has emerged as an adjunct tool in the diagnosis of regional wall motion abnormalities from CAD. We performed a systematic review and meta-analysis to assess the efficacy of TDI indices in the diagnosis of CAD. We searched MEDLINE and the Cochrane Library for controlled studies comparing TDI measurements in those with and without CAD as confirmed by coronary angiography. Meta-analyses of mean differences in TDI velocities between these populations were performed. Screening of titles and abstracts followed by full-text screening identified 8 studies. At rest, TDI was associated with a significant decrease in the pooled maximum systolic velocity among CAD patients compared to those without CAD [mean difference (MD): -0.66; 95% confidence interval (CI): -0.98 to −0.34]. There were no significant differences in maximum early and late diastolic velocities. Post-stress, TDI was associated with a significant decrease in maximum early diastolic velocity (MD: -1.91; 95% CI: -2.74 to −1.09) and maximum late diastolic velocity (MD: -1.57; 95% CI: -2.95 to −0.18) among CAD patients compared to those without CAD. There was no significant difference in maximum systolic velocity post-stress. Our results suggest that TDI may have a role in the evaluation of CAD. Future studies should evaluate the incremental value of TDI velocities over LV ejection fraction and two dimensional wall motion analysis in the detection of CAD and assessment of its severity. (Word Count: 249)

Keywords:
Systematic review; Meta-analysis; Tissue Doppler; Echocardiography; Coronary artery disease