Circulation. 2001;104:1059-1065
doi: 10.1161/hc3501.093818
doi: 10.1161/hc3501.093818
(Circulation. 2001;104:1059.)
© 2001 American Heart Association, Inc.
Basic Science Reports |
Noninvasive Quantification of the Contractile Reserve of Stunned Myocardium by Ultrasonic Strain Rate and Strain
From the Department of Cardiology, University Hospital Gasthuisberg, Leuven, Belgium, and the Medical University Clinic (J.S.), Würzburg, Germany.
Correspondence to George R. Sutherland, Department of Cardiology, University Hospital Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium. E-mail george.sutherland{at}uz.kuleuven.ac.be
Background— We sought to investigate ultrasonic strain rate and strain as new indices to quantify the contractile reserve of stunned myocardium during dobutamine infusion.
Methods and Results— Stunning of the left ventricular posterior wall was induced in 9 closed-chest pigs after 30 minutes of severe hypoperfusion followed by 60 minutes of reperfusion of the left circumflex coronary artery territory. A second group of 7 animals had no coronary occlusion and served as normal controls. An incremental dobutamine infusion protocol was used in both groups. Changes in regional radial function were monitored by use of ultrasound-derived maximal systolic radial strain rate (SR) and systolic strain (
). In the control group, dobutamine induced an increase in both SR and maximal dP/dt, which correlated linearly (r=0.85). Conversely, values increased at low doses of dobutamine (2.5 to 5 µg · kg-1 · min-1) but decreased during higher infusion rates (10 to 20 µg · kg-1 · min-1). During circumflex hypoperfusion, SR and of the posterior wall decreased from 5.0±0.3 s-1 and 63±6% to 2.9±0.3 s-1 and 27±4%, respectively (P<0.01). After 60 minutes of reperfusion, SR and failed to fully resume because of stunning, averaging 3.6±0.2 s-1 and 35±3%, respectively (P=0.12 versus ischemia, P<0.05 versus baseline). During dobutamine infusion, SR increased at 5 µg · kg-1 · min-1 and exceeded baseline values at 20 µg · kg-1 · min-1 (P<0.05), whereas increased only at high doses and remained below baseline levels (P<0.05).
Conclusions— The changes in regional function of stunned myocardium during inotropic stimulation could be characterized by use of ultrasonic deformation parameters. During dobutamine infusion, strain-rate values quantified the contractile reserve better than strain values.
Key Words: stunning, myocardial • stress • echocardiography
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