Myocardial Doppler velocity imaging—a quantitative technique for interpretation of dobutamine echocardiography

Yamada, Elina; García, Mario J.; Thomas, James D.; Marwick, Thomas H.

doi:10.1016/s0002-9149(98)00447-0

Cited by 82 publications

(55 citation statements)

References 17 publications

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“…However, regional myocardial velocities are also generated by tethering effects from other myocardial segments and by translational motion of the entire heart, and this could limit the ability of tissue Doppler imaging to quantify regional function. Such a limitation was suggested by Yamada et al, 18 who studied myocardial velocity responses to dobutamine in patients with coronary artery disease compared with normal subjects. They demonstrated reduced velocity responses to dobutamine in nonischemic segments in the coronary patients.…”

Section: Myocardial Strain and Strain Rate Versus Tissue Velocitiesmentioning

confidence: 99%

Myocardial Strain by Doppler Echocardiography

et al. 2000

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Background-Myocardial strain is a measure of regional deformation, and by definition, negative strain means shortening and positive strain, elongation. This study investigates whether myocardial strain can be measured by Doppler echocardiography as the time integral of regional velocity gradients, using sonomicrometry as reference method. Methods and Results-In 13 anesthetized dogs, myocardial longitudinal strain was measured on apical images as the time integral of regional Doppler velocity gradients. Ultrasonic segment-length crystals were placed near the left ventricular (LV) apex and near the base. Apical ischemia was induced by occluding the left anterior descending coronary artery (LAD), and preload was increased by saline.

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Section: Myocardial Strain and Strain Rate Versus Tissue Velocitiesmentioning

confidence: 99%

Myocardial Strain by Doppler Echocardiography

et al. 2000

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“…Because TDI facilitates quantitative evaluation of regional wall motion abnormalities, many studies have tried to determine LV myocardial viability during dobutamine stress using pulsed TDI [43][44][45] and color-coded TDI [46][47][48][49][50]. There is a possibility that ischemic and nonischemic segments interact with each other (tethering), resulting in a decrease in systolic motion velocity in the nonischemic segment [43].…”

Section: Systolic Functionmentioning

confidence: 99%

“…There is a possibility that ischemic and nonischemic segments interact with each other (tethering), resulting in a decrease in systolic motion velocity in the nonischemic segment [43]. However, Sw1 along the long axis during the isovolumic contraction phase is more sensitive than systolic parameters during the ejection phase in detecting myocardial viability [45,51].…”

Section: Systolic Functionmentioning

confidence: 99%

The Role of Tissue Doppler Imaging as a New Diagnostic Option in Evaluating Left Ventricular Function

Oki

2003

J Echocardiogr

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In general, pump function and myocardial contractility should be assessed when evaluating left ventricular (LV) systolic function. Ejection fraction obtained from left ventriculography is routinely used as an index of pump function, and the maximum value of the first derivative of LV pressure curve (peak dP/dt) has been used as an index of myocardial contractility. On the other hand, active relaxation of the LV myocardium during early diastole and LV passive filling or compliance during mid-to late diastole are important factors in evaluating LV diastolic function. To obtain this information, the time constant of the LV pressure decay during isovolumic diastole (tau) and LV end-diastolic pressure, which are calculated from the LV pressure curve recorded during cardiac catheterization, is used. However, invasive hemodynamic measurements cannot be performed in all patients, nor are they appropriate for follow-up evaluation involving repeated examinations.Recently, routine echocardiography has facilitated the noninvasive evaluation of LV systolic and diastolic function. The percent fractional shortening of the LV based on M-mode echocardiography and the LV ejection fraction determined by two-dimensional echocardiography are indices of LV pump function, and therefore cannot accurately evaluate LV myocardial contractility. On the other hand, "diastology" has become an important clinical topic [1]. There are several reasons why assessment of diastolic function is important: 1) 30 to 40% of patients evaluated for congestive heart failure have normal LV pump function [2,3]; 2) the transmitral flow velocity pattern, which is recorded using the pulsed Doppler method, may be an index for noninvasive evaluation of LV diastolic function [4]; and 3) the prognosis is poor in patients with LV systolic dysfunction and pseudonormalization or restrictive pattern of the transmitral flow velocity [5,6]. However, it has been shown that the diastolic indices obtained from transmitral and pulmonary venous flow velocities are influenced by loading conditions, especially by the pre- The Role of Tissue Doppler Imaging as a New Diagnostic Option in Evaluating Left AbstractThe widespread use of the pulsed Doppler echocardiography has facilitated the noninvasive evaluation of hemodynamic abnormalities of the left atrium and left ventricle (LV) based on transmitral and pulmonary venous flow velocity patterns. However, it has been shown that loading conditions, especially preload, influence the indices obtained from these velocity patterns. Recently, tissue Doppler imaging (TDI) has been applied to the clinical setting to assess LV myocardial function. In particular, this procedure has the following characteristics: 1) it can provide circumferential and longitudinal information for the LV myocardium; 2) the early diastolic LV myocardial parameters determined by TDI are not influenced by preload; 3) LV myocardial contractility can be evaluated from the early systolic parameters; 4) LV systolic and diastolic asynchrony can be detected; 5) myoca...

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Section: Discussionmentioning

confidence: 99%

“…[12][13][14][15]18) For the diagnosis of ischemic segment of LV, numerous studies have reported the importance of myocardial systolic S velocity analysis during dobutamine stress. 17,18) But limited data has been published using PWTD diastolic velocities. Yamada, et al reported that PWTD diastolic velocities could be analysed in only 29 % of the segments during dobutamine stress, and the E wave in the ischemic segments at each stage of the dobutamine protocol was significantly smaller than the E wave in the normal segments.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of Pulse-wave Doppler Tissue Sampling and Dobutamine Stress Echocardiography for Identification of False Positive Inferior Wall Defects in SPECT.

et al. 2000

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SUMMARYFalse positive inferior wall perfusion defects restrict the accuracy of SPECT in diagnosis of coronary artery disease (CAD). Pulse-Wave Tissue Doppler (PWTD) has been recently proposed to assess regional wall motion velocities. The objectives of this study were to evaluate the presence of CAD by using PWTD during dobutamine stress echocardiography (DSE) in patients with an inferior perfusion defect detected by SPECT and compare PWTD parameters of normal cases with patients who had inferior perfusion defect and CAD.Sixty-five patients (mean age 58 ± 8 years, 30 men) with a normal LV systolic function at rest according to echocardiographic evaluation with an inferior ischemia determined by SPECT and a control group (CG) of 34 normal cases (mean age 56 ± 7 years, 16 men) were included in this study. All patients underwent a standard DSE (up to 40 µg / kg / min with additional atropine during sub-maximum heart rate responses). Pulse-wave Doppler tissue sampling of inferior wall was performed in the apical 2-chamber view at rest and stress. The coronary angiography was performed within 24 hours. The results were evaluated for the prediction of significant right coronary artery (RCA) and / or left circumflex coronary artery (CX) with narrowing (≥ 50 % diameter stenosis, assessed by quantitative coronary angiography).It was observed that the peak stress mean E / A ratio was lower in patients

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Myocardial Doppler velocity imaging—a quantitative technique for interpretation of dobutamine echocardiography

Cited by 82 publications

References 17 publications

Myocardial Strain by Doppler Echocardiography

Myocardial Strain by Doppler Echocardiography

The Role of Tissue Doppler Imaging as a New Diagnostic Option in Evaluating Left Ventricular Function

Usefulness of Pulse-wave Doppler Tissue Sampling and Dobutamine Stress Echocardiography for Identification of False Positive Inferior Wall Defects in SPECT.

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