Regional left ventricular diastolic dysfunction evaluated by tissue Doppler imaging as an earlier signal of myocardial ischemia. Experimental study of induced ischemia and reperfusion in pigs

Garcı́a-Fernández, Miguel Ángel; Azevedo, J; Puerta, Pablo; Moreno, Mar; SanRoman, D; Torrecilla, Esteban G.; de, Esteban; Vallejo, José Luis; Delcan, J. L.

doi:10.1016/s0735-1097(96)82092-4

Cited by 9 publications

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“…Although the ejection fraction and fractional shortening express the ventricular performance with confidence, suitable assessment of the myocardium in the different phases of the cardiac cycle may help to better understand some pathologic conditions. Alterations in myocardial motion during the ventricular rapid filling phase is consi- dered an early marker of cardiac commitment in hypertension 10 . Also, in the early stages of coronary disease, an increase may occur in the time of E wave deceleration in the mitral inflow, even though systolic function is preserved.…”

Section: Discussionmentioning

confidence: 99%

“…Doppler tissue imaging can also demonstrate: alterations in ventricular relaxation, initially, in certain myocardial segments, preceding alterations in the global commitment of ventricular filling. Regional diastolic dysfunction may be, therefore, a very early indicator of ischemia 10 , but to recognize parameters alterations obtained with Doppler tissue imaging, it is necessary to know its normal values 11,12 .…”

Section: Discussionmentioning

confidence: 99%

“…Despite this, a limitation of this method is that it does not enhance the difference between the velocities observed in the apical and basal segments. Doppler tissue imaging, as with any type of Doppler, depends on the angle at which the ultrasound beam reflects, that is, the more parallel the beam is to the direction of the main displacement of the structure to be analyzed, the more accurate is the velocity measured measurement 13,14 . The motion of the left ventricular myocardium is very complex.…”

Section: Discussionmentioning

confidence: 99%

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Study of the Myocardial Contraction and Relaxation Velocities through Doppler Tissue Imaging Echocardiography: A New Alternative in the Assessment of the Segmental Ventricular Function

Silva¹,

Ferreira²,

Peixoto³

et al. 2002

Arq. Bras. Cardiol.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Study of the Myocardial Contraction and Relaxation Velocities through Doppler Tissue Imaging Echocardiography: A New Alternative in the Assessment of the Segmental Ventricular Function

Silva¹,

Ferreira²,

Peixoto³

et al. 2002

Arq. Bras. Cardiol.

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“…Transient ischemia as produced experimentally in animals 6,19 or in patients undergoing angioplasty 7 can produce signi cant reversible reduction of Ve and the Ve/Va ratio. Stressproducing ischemia has the same effect, although detection of this effect during dobutamine stress testing is prevented in 40% 17 to 71% 18 of cases by fusion of the early and late waves at high heart rates.…”

Section: Diastolic Myocardial Functionmentioning

confidence: 99%

Comparison of Two‐Dimensional Echocardiography and Pulsed Doppler Tissue Imaging during Dobutamine‐Atropine Stress Testing to Detect Coronary Artery Disease

et al. 2001

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In order to compare the diagnostic accuracy of two-dimensional (2-D) echocardiography and pulsed Doppler tissue imaging (pDTI) during dobutamine-atropine stress testing (DAST) to detect significant coronary lesions, 41 patients underwent DAST (up to 40 microg/k/min of dobutamine with additional atropine during submaximal heart rate responses) and coronary angiography. Pulsed Doppler tissue sampling of territories corresponding to the left anterior descending (LAD), left circumflex (LCx), and right coronary arteries (RCAs) were performed in the apical four-chamber plus aorta and two-chamber apical views. The measurements were repeated at rest, at low dose (10 microg/k/min), and at peak stress. Pulsed DTI measurements included peak early systolic (Vs), peak early diastolic (Ve), and peak late diastolic (Va) velocities. Harmonic 2-D echocardiography was recorded at rest, low dose, peak stress, and recovery, and compared with pDTI assessment. Positive 2-D echocardiography was considered as infarction or ischemic response. The results were evaluated for the prediction of significant coronary stenosis (50% luminal narrowing). Feasibility of pDTI was 100%, 95%, and 98% for the LAD, the LCx, and RCA territories, respectively. At rest, Vs in territories supplied by arteries with coronary artery disease (CAD) (6.3 +/- 2.0 cm/sec) was not different from those without (6.6 +/- 2.1 cm/sec). Vs increased less in territories supplied by arteries with than without CAD (75 +/- 107% vs 102 +/- 69%, P = NS). Ve was lower in territories with CAD at rest (6.0 +/- 2.1 cm/sec vs 8.2 +/- 3.4 cm/sec, P < 0.0001) and low dose (7.2 +/- 2.1 cm/sec vs 8.8 +/- 3.6 cm/sec, P < 0.01), but similar at peak stress (7.6 +/- 3.5 cm/sec vs 8.1 +/- 3.3 cm/sec). Ve increase was similar in territories with (36 +/- 74%) than without CAD (15 +/- 6 4%). Va was similar at rest and low dose in territories with and without CAD (9.2 +/- 2.7 cm/sec vs 9.1 +/- 2.3 cm/sec and 10.9 +/- 3.1 vs 10.3 +/- 3.6 cm/sec, respectively), but lower at peak stress in territories with CAD (13.3 +/- 4.6 cm/sec vs 15.3 +/- 4.5 cm/sec, P = 0.05). The Va increase was lower in territories with CAD (43 +/- 37% vs 77 +/- 72%, P < 0.05). In a territory-based analysis, a failure to achieve Vs > or =10.5 cm/sec at peak stress in the LAD and LCx, and > or =10.0 cm/sec in the RCA territory, was found to be the more accurate limit to detect CAD in the corresponding arteries: sensitivity (95% confidence intervals): 63% (55-71), P = NS vs 2-D echocardiography: 59% (51-67); specificity 76% (68-84), P < 0.01 vs. 2-D echocardiography: 95% (89-100); and accuracy 69% (63-75), P = NS vs 2-D echocardiography: 76% (70-82). Thus, pDTI is feasible during DAST but not more accurate than 2-D echocardiography for the detection of significant CAD in a territory-based study.

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Garcı́a-Fernández¹,

Moreno²

1997

Stress Echocardiography

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Regional left ventricular diastolic dysfunction evaluated by tissue Doppler imaging as an earlier signal of myocardial ischemia. Experimental study of induced ischemia and reperfusion in pigs

Cited by 9 publications

References 0 publications

Study of the Myocardial Contraction and Relaxation Velocities through Doppler Tissue Imaging Echocardiography: A New Alternative in the Assessment of the Segmental Ventricular Function

Study of the Myocardial Contraction and Relaxation Velocities through Doppler Tissue Imaging Echocardiography: A New Alternative in the Assessment of the Segmental Ventricular Function

Comparison of Two‐Dimensional Echocardiography and Pulsed Doppler Tissue Imaging during Dobutamine‐Atropine Stress Testing to Detect Coronary Artery Disease

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