From Noninvasive Cardiac Imaging Laboratories, Section of Cardiology,
Department of Medicine, The University of Chicago Medical Center, Chicago,
Ill.
Correspondence to Roberto M. Lang, MD, MC5084, University of Chicago Medical Center, 5841 S Maryland Ave, Chicago, IL 60637. E-mail rlang{at}medicine.bsd.uchicago.edu
Background—Diastolic
wall motion asynchrony is a major determinant of impaired left
ventricular (LV) filling in patients with concentric
hypertrophy and coronary artery disease. We
evaluated the ability of Color Kinesis, a new
echocardiographic technique that color-encodes
endocardial motion, to quantitatively assess global and regional LV
filling properties.
Methods and Results—Color Kinesis images and mitral and
pulmonary vein flow Doppler data were acquired in 29
patients with LV hypertrophy and 29 age-matched control
subjects. In addition, Color Kinesis data were correlated to
coronary angiographic findings in 15 patients with suspected
coronary artery disease. Segmental analysis of Color
Kinesis images was used to obtain time histograms of regional
diastolic fractional area change, wherein early and late
peaks (peaks 1 and 2) reflected rapid LV filling and atrial
contraction, respectively. Regional mean LV filling time and filling
curves were used to objectively identify diastolic
endocardial motion asynchrony in patients with LV
hypertrophy and coronary artery disease. None of
the mitral and pulmonary vein Doppler indices
differentiated patients with normalized mitral Doppler profile
(n=13) from control subjects, whereas reduced peak1/peak2 ratio and
prolonged mean filling time indicated augmented contribution of atrial
contraction toward LV filling (P<.05). In 22 of 25
patients with LV hypertrophy and preserved systolic
function and in all patients with coronary artery disease,
delayed diastolic endocardial motion was observed in at
least one segment.
Conclusions—Analysis of Color Kinesis images provides
objective assessment of global and regional LV filling properties and
allows identification of both diastolic dysfunction in
patients with normalized Doppler indices and wall motion
asynchrony.
© 1998 American Heart Association, Inc.
Clinical Investigation and Reports
Quantitative Evaluation of Global and Regional Left Ventricular Diastolic Function With Color Kinesis
Key Words: echocardiography • diastole • hypertrophy • coronary disease
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