page_title: Tissue Doppler echocardiography
section_title: Clinical use
hierarchical_section_title: Tissue Doppler echocardiography / Pulsed tissue Doppler echocardiography / Clinical use
caption_attribution_description: Single spectral tissue velocity curve from the mitral annulus. The curve shows velocities towards the probe (positive velocity) in systole, and away from the probe (negative velocities) in diastole. The most useful measures are the peak velocities, in systole S' and in early diastole (e') and late diastole during atrial contraction (a').
context_page_description: Tissue Doppler echocardiography is a medical ultrasound technology, specifically a form of echocardiography that measures the velocity of the heart muscle through the phases of one or more heartbeats by the Doppler effect of the reflected ultrasound. The technique is the same as for flow Doppler echocardiography measuring flow velocities. Tissue signals, however, have higher amplitude and lower velocities, and the signals are extracted by using different filter and gain settings. The terms tissue Doppler imaging and tissue velocity imaging are usually synonymous with TDE because echocardiography is the main use of tissue Doppler.
  Like Doppler flow, tissue Doppler can be acquired both by spectral analysis as pulsed Doppler and by the autocorrelation technique as colour tissue Doppler. While pulsed Doppler only acquires the velocity at one point at a time, colour Doppler can acquire simultaneous pixel velocity values across the whole imaging field. Pulsed Doppler on the other hand, is more robust against noise, as peak values are measured on top of the spectrum, and are unaffected of the presence of clutter.
context_section_description: Pulsed wave spectral tissue Doppler has become a universal tool that is part of the general echocardiographic examination. Like any other echocardiographic measurement, measures by tissue Doppler should be interpreted in the context of the whole examination. The velocity curves are in general taken from the base of the mitral annulus at the insertion of the mitral leaflets, in the septal and lateral points of the four chamber view, and eventually the anterior and inferior points of the two-chamber views. For the right ventricle it is customary to use the lateral point of the tricuspid annulus only. Averaging peak velocities from the septal and lateral point has become common, although it has been shown that averaging all four points mentioned above, gives significantly less variability
  
  The method measures annular velocities to and from the probe during the heart cycle.  
  Annular velocities summarize the longitudinal contraction of the ventricle during systole, and elongation during diastole. Peak velocities are commonly used.
caption: Single spectral tissue velocity curve from the mitral annulus. The curve shows velocities towards the probe (positive velocity) in systole, and away from the probe (negative velocities) in diastole. The most useful measures are the peak velocities, in systole S' and in early diastole (e') and late diastole during atrial contraction (a').
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