Quantitative systolic and diastolic transmyocardial velocity gradients assessed by M-mode colour Doppler tissue imaging as reliable indicators of regional left ventricular function after acute myocardial infarction

Abstract

AimsThe aim of this study was to determine whether myocardial velocity gradients assessed by M-mode colour Doppler tissue imaging could be of clinical relevance and represent reliable indicators of regional left ventricular function after acute myocardial infarction. Methods and ResultsAmong 64 consecutive patients with a first acute myocardial infarction, in 50 who had a marked asynergy in the parasternal short-axis view at the mid-papillary muscle level, myocardial velocities and velocity gradients were assessed in the anteroseptum and posterior wall by M-mode Doppler tissue imaging. Similar measurements were obtained in 11 matched healthy volunteers who served as a control group.In patients with anterior myocardial infarction, the peak myocardial velocity gradient in the anteroseptum was significantly lower when compared with controls (mean [SD] 0·0 0·5 vs 1·1 0·7 s 1 during systole, P<0·01; and 0·3 0·6 vs 2·0 0·5 s 1 during diastole, P<0·01). Conversely, the peak systolic myocardial velocity gradient in the posterior wall was significantly higher than in controls (2·6 1·2 vs 1·8 1·2 s 1 , P<0·05).In patients with inferior myocardial infarction, the peak velocity gradient in the posterior wall was significantly lower when compared with healthy subjects (0·9 0·6 vs 1·8 1·2 s 1 during systole and 1·4 1·4 vs 4·9 1·2 s 1 during diastole, both P<0·01). The peak systolic tissue velocity gradient in the anteroseptum was significantly higher than in controls (2·1 1·0 vs 1·1 0·7 s

Ultrasound Strain Imaging of Altered Myocardial Stiffness

“…The reduction in diastolic SR has also been briefly reported. [11][12][13] Our study is the first to validate the behavior of regional diastolic SR and strain parameters against conventional indices of myocardial stiffness.…”

“…6 -9 Regional functional assessment after acute myocardial infarction (MI) has been focused on measurement of active systolic function. 7,10 -15 Few studies describe diastolic deformation, [11][12][13] but none have specifically related passive diastolic deformation to myocardial stiffness and viability status. We hypothesize that passive deformation may disclose information on myocardial viability, particularly in conditions of persistent systolic dysfunction, such as stunning and acute MI.…”

In Vivo Assessment of Myocardial Stiffness with Acoustic Radiation Force Impulse Imaging

“…These methods have shown promise in the detection of ischemic or infarcted myocardium (Garot et al, 1999;Lyseggen et al, 2005;Pislaru et al, 2004). However, without measuring stress, these images are vulnerable to misinterpretation as observed variations could be due to the intrinsic non-uniform deformation of the heart.…”

Quantitative Assessment of Intrinsic Regional Myocardial Deformation by Doppler Strain Rate Echocardiography in Humans

“…[3][4][5][6][7][8] TDI offers no solution, however, to the issue of distinguishing local velocity from translational motion and tethering effects from other regions. A potentially more specific measure of regional function would be quantification of regional deformation or strain.…”