Quantitative wall motion analysis by colour tissue Doppler echocardiography during low‐dose dobutamine infusion to distinguish between ischemic and nonischemic dilated cardiomyopathy

Abstract

during this period. During total follow-up, Australian and Scottish patients accumulated 0.6 vs 0.9 days of hospitalisation/patient/month respectively (NS). On multivariate analysis (including country of origin), event-free survival was significantly correlated with severe renal impairment (relative risk 2.0, 95% CI 1.1-3.4, P < 0.01) and a previous admission for HF (relative risk 1.7, 95% CI 1.1-2.6, P < 0.01). Conclusions:Overall, these data suggest that predominantly old and frail HF patients are common to both Australia and Scotland. Moreover, treatment and outcome data suggest that post-discharge health outcomes are likely to be independent of the health-care system in which the patient is managed and more likely to be dependent on the syndrome itself. The combined Doppler myocardial performance index (MPI) is defined as the sum of isovolumic times divided by ejection time (ET). The sum of isovolumic contraction and relaxation times is obtained by subtracting ET from the interval between end and onset of mitrai inflow. MPI is an integrated index of systolic and diastolic LV function. From retrospective studies it appears to be a promising prognostic marker in dilated cardiomyopathy and amyloidosis. P100/10383 I Value of combined Doppler myocardialTo determine the distribution of MPI values in patients with advanced heart failure and its relations to other variables, we prospectively examined 82 in-patients (age 51.7 4-7.8 years, NYHA 2.7 4-0.8, EF 21.8 4-5.0%, VO2max 16.1 4-5.2 ml/kg/min) referred to our department as potential transplant candidates for dilated cardiomyopathy or coronary heart disease. MPI was assessed in addition to standard evaluation.Results: MPI values in this selected population retain a normal distribution pattern with the average of 0.885 and SD 0.331. MPI correlates significantly with LVEF (r = -0.36, p0.02, n = 44) and with VE/VCO2 and VE/VO2 at anaerobic threshold (r = 0.43, p0.01 and r = 0.45, p0.01, n = 44) while there was no significant correlation between MPI and VOamax (r = 0.14, ns, n = 65). There were no relations of MPI to HR, BP, CO, SV, PAP, CWP, nor to the degree of mitral regurgitation. Condusion:MPI as an integrated marker of systolic and diastolic function of the left ventricle enables further differentiation according to extent of functional impairment also in advanced heart failure. It can be easily obtained in vast majority of patients, is nongeometric and relatively independent on actual hemodynamic state. Its value for prognostic stratification in advanced heart failure remains to be determined in a prospective study. In patients with chronic congestive heart failure, detection of coronary artery disease is mandatory in order to guide therapy. The selection of heart failure patients who should undergo a coronary arteriography has become more important as the population of elderly patients is growing. The aim of the study was to determine whether Tissue Doppler Echocardiography (TDE) performed at rest in patients with dilated cardiomyopathy could identify noninva...

Myocardial perfusion SPECT and dobutamine stress tissue Doppler imaging in evaluation of patients with stable angina pectoris

“…Our finding of blunted myocardial tissue mean systolic velocity related to ischemia was consistent with the results in previous reports of unselected population of CAD, patients with unstable angina pectoris, acute MI, patients with stunned, hibernating, scarred myocardium and dilated cardiomyopathy (7)(8)(9)(10)(11). TDI records quantitative LV wall motion velocities (12).…”