Poor Correlation between Fetal Tissue Doppler Imaging and Pulsed Wave Myocardial Performance Indices

Introduction: Both Tissue Doppler Imaging (TDI) and Pulsed Wave Doppler (PWD) Myocardial Performance Indices (MPI) have been proposed as tools for functional fetal cardiology. We wished to determine if there was any correlation between TDI MPI and PWD MPI.Methods: A cohort of uncomplicated women with morphologically normal singleton fetuses between 22 and 39 weeks gestation were recruited. A single sonologist acquired Doppler waveforms for evaluation of both left and right TDI-MPI and PWD-MPI. The PWD MPI values were calculated using a previously published algorithm and the TDI MPI time intervals were measured manually by a single operator.Results: Achievability and repeatability were high for both modalities. TDI produced significantly lower right MPI values, yet significantly higher left MPI values, potentially reflecting their evaluation of physiologically different events, blood flow versus myocardial contraction. Discussion/Conclusion: This study demonstrates that MPI measured from PWD and TDI have a weak correlation and cannot be used interchangeably, even with the exclusion of suboptimal TDI-MPI scans from the analysis. Given the lack of correlation between the two methods, the high variation in TDI waveform and the lack of unified approach to TDI analysis we feel further research is needed before adoption of this technique.

Automated summary

This study compares the correlation between Tissue Doppler Imaging (TDI) and Pulsed Wave Doppler (PWD) Myocardial Performance Indices (MPI), and finds a weak correlation between the two methods. Given the high variation in TDI waveform and the lack of unified approach to TDI analysis, further research is needed before adoption of this technique.