(Circulation. 1997;95:2423-2433.)
© 1997 American Heart Association, Inc.
Articles |
From the Divisions of Cardiology (J.G., W.A.M., V.K.G.) and Anesthesiology and Critical Care Medicine (D.P.S., M.R.P.), University of Pittsburgh (Pa).
Correspondence to John Gorcsan III, MD, Division of Cardiology, University of Pittsburgh Medical Center, 200 Lothrop St, Pittsburgh, PA 15213-2582. E-mail gorcsan{at}a1.isd.upmc.edu
Background Tissue Doppler imaging (TDI) is a novel method of color-coding myocardial velocity on-line. The objective of the present study was to evaluate endocardial velocity with TDI as a method of objectively quantifying alterations in regional contractility over a wide range induced by inotropic modulation.
Methods and Results Myocardial length crystals were used to simultaneously assess regional left ventricular (LV) function, and high-fidelity pressure and conductance catheters were used to assess global LV contractility by pressure-volume relations in nine open-chest dogs. Mid-LV M-mode and two-dimensional color TDI images were recorded during control and inotropic modulation stages with dobutamine and esmolol. Predicted significant increases in TDI indices occurred with dobutamine: peak systolic velocity of 4.41±1.07 to 6.67±1.07 cm/s*, systolic time-velocity integral (TVI) of 0.43±0.12 to 0.62±0.10 cm*, and diastolic TVI of 0.49±0.11 to 0.71±0.17 cm*. Opposing significant decreases occurred with esmolol: peak systolic velocity of 4.46±0.94 to 2.31±0.81 cm/s*, systolic TVI of 0.47±0.12 to 0.19±0.11 cm*, and diastolic TVI of 0.55±0.11 to 0.33±0.11 cm* (*all P<.001 versus control). Changes in TDI peak systolic velocity were correlated with changes in fractional shortening (r=.88) and shortening velocity (r=.87) by sonomicrometry. Changes in TDI peak velocity from multiple mid-LV sites also correlated significantly with maximal elastance (r=.85±.04) from pressure-volume relations.
Conclusions TDI measures reflect directional and incremental alterations in regional and global LV contractility and have the potential to quantify regional LV function.
Key Words: dynamics echocardiography myocardium mechanics imaging
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F Larrazet, D Pellerin, D Daou, S Witchitz, C Fournier, A Prigent, and C Veyrat Concordance between dobutamine Doppler tissue imaging echocardiography and rest reinjection thallium-201 tomography in dysfunctional hypoperfused myocardium Heart, October 1, 1999; 82(4): 432 - 437. [Abstract] [Full Text] [PDF] |
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G. Geskin, C. M. Kramer, W. J. Rogers, T. M. Theobald, D. Pakstis, Y.-L. Hu, and N. Reichek Quantitative Assessment of Myocardial Viability After Infarction by Dobutamine Magnetic Resonance Tagging Circulation, July 21, 1998; 98(3): 217 - 223. [Abstract] [Full Text] [PDF] |
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G. Derumeaux, P. Mulder, V. Richard, A. Chagraoui, C. Nafeh, F. Bauer, J.-P. Henry, and C. Thuillez Tissue Doppler Imaging Differentiates Physiological From Pathological Pressure-Overload Left Ventricular Hypertrophy in Rats Circulation, April 2, 2002; 105(13): 1602 - 1608. [Abstract] [Full Text] [PDF] |
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T. Edvardsen, S. Urheim, H. Skulstad, K. Steine, H. Ihlen, and O. A. Smiseth Quantification of Left Ventricular Systolic Function by Tissue Doppler Echocardiography: Added Value of Measuring Pre- and Postejection Velocities in Ischemic Myocardium Circulation, April 30, 2002; 105(17): 2071 - 2077. [Abstract] [Full Text] [PDF] |
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