Relationship Between Noninvasive Reperfusion Criteria and Pulsed‐Wave Tissue Doppler Parameters in Patients With Acute Myocardial Infarction Receiving Thrombolytic Therapy

Abstract

Several studies have proven that noninvasive reperfusion criteria (NRC) have prognostic significance in patients receiving thrombolytic therapy (TT) after acute myocardial infarction (acute MI). In this study, we investigated the relationship between NRC and pulsed tissue Doppler (PTD) parameters in patients receiving TT after acute MI, and the role of PTD in the management and follow-up of patients with acute MI. The study group(n= 41)was divided into four subgroups defined as: anterior and posterior MI, with or without NRC. In the first PTD measurements (2-3 days after acute MI), all acute MI patients had significantly smaller peak systolic (S-wave) velocity in all evaluated segments and longer Q-Speak durations (time elapsed from the inscription of the Q-wave on the surface ECG to the peak of the S-wave in PTD) as compared with control patients(n= 22; P < 0.001 for both). Among the diastolic parameters, the E/A ratio was significantly smaller in the study group compared with the control group(P < 0.001). Among the patients who had received TT in the first 2 hours, those patients who had NRC displayed significantly higher peak S-wave values in all evaluated segments than those without NRC(P < 0.05). The second PTD study (4-5 weeks after acute MI), revealed that the difference between the systolic PTD parameters of the noninfarcted regions of the study and control groups disappeared. Infarct-related segments, however, displayed significant improvement only in patients having NRC. There was a significant positive correlation between the mean mitral annular S-wave velocity and left ventricular ejection fraction(r = 0.59, P < 0.001). In conclusion, a significant relationship was observed between the PTD parameters and the NRC, which are known to have prognostic significance.

Relationship between Systolic Myocardial Velocity Obtained by Tissue Doppler Imaging and Left Ventricular Ejection Fraction: Systolic Myocardial Velocity Predicts the Degree of Left Ventricular Dysfunction in Heart Failure

“…Thus, Sm obtained by TDI has been suggested to be an alternative method in recent years in the assessment of systolic myocardial functions of various cardiac diseases 6–13 . In the studies so far, it has been demonstrated that in mixed groups, there has been an agreement between Sm derived from PWD‐TDI or color M‐mode TDI and LVEF obtained by radionuclide or echocardiographic Simpson's method 6,13–18 . However, the correlation between Sm and LVEF has not been studied adequately in healthy subjects and in patients with HF separately.…”

“…An agreement between Sm obtained by pulsed‐wave Doppler (PWD) or by color M‐mode TDI and LVEF obtained by various other methods has already been assessed in mixed groups, and the two parameters have been determined to agree with each other 6,13–18 . However, the agreement between Sm and LVEF has not been adequately studied in healthy subjects and those with heart failure (HF) separately.…”

“…[6][7][8][9][10][11][12][13] An agreement between Sm obtained by pulsed-wave Doppler (PWD) or by color Mmode TDI and LVEF obtained by various other methods has already been assessed in mixed groups, and the two parameters have been determined to agree with each other. 6,[13][14][15][16][17][18] However, the agreement between Sm and LVEF has not been adequately studied in healthy subjects and those with heart failure (HF) separately. In addition, although the correlation between LVEF and functional capacity, a significant indicator of mortality, is already known, there are not enough data available on the relation between Sm and functional capacity in patients with HF.…”

Quantification of Global Left Ventricular Systolic Dysfunction in Patients with Coronary Artery Disease by Pulsed Doppler Tissue Imaging: The Value of Mitral Annulus Time Intervals

“…Exact timing of DTI velocities in relation to the different phases of the cardiac cycle is possible by simultaneous recording of tissue velocities and ECG signals. Systolic time intervals measured by pulsed DTI had been used to evaluate regional left ventricular systolic dysfunction in patients with CAD 12 . However, the usefulness of mitral annulus systolic time intervals for the assessment of global left ventricular systolic function has not yet been reported.…”

“…Systolic time intervals measured by pulsed DTI had been used to evaluate regional left ventricular systolic dysfunction in patients with CAD. 12 However, the usefulness of mitral annulus systolic time intervals for the assessment of global left ventricular systolic function has not yet been reported. In the present study, both PEP and TS at all the four mitral annular sites were significantly longer in the MI group than that in the control and the AP groups, while LVEF was significantly lower in the MI group compared with that in the control and the AP groups.…”