Regional myocardial velocity imaged by magnetic resonance in patients with ischaemic heart disease.

Abstract

Objective-To assess the pattern of global and regional left ventricular long axis motion during early diastole in patients with ischaemic heart disease with and without myocardial infarction using magnetic resonance velocity mapping. Design-Prospective study of 26 patients with a history of myocardial infarction (age 29-78, mean 55 years) and 21 patients with coronary artery disease without infarction (age range 39-71, mean 58 years). Values were compared with a control group (19 controls, age 35-76, mean 52 years) with a low likelihood of cardiovascular disease. Results-Regional long axis velocity varied with time and position around the ventricle. All measurements were taken at the time of maximum early diastolic long axis velocity. Patients with coronary artery disease without infarction had lower values for maximum (mean (SD)) (99 (30) v 125 (33) mm/s, P < 0.05) and mean peak early diastolic wall motion (63 (13) v 82 (22) mm/s, P < 0.05) than controls. The coefficient of variation showed greater inhomogeneity of relaxation in patients than in controls (38 (18)% v 27 (10)%). All values were lower in patients with previous infarction than in patients with coronary artery disease without infarction and normal subjects. In patients with previous myocardial infarction the maximum (mean (SD)) early diastolic velocity was 80 (22) mm/s (P < 0-01 compared with controls and P < 0 05 compared with patients without infarction) and the mean (SD) velocity was 47 (18) mm/s (P < 0-01 compared with controls).

Clinical indications for cardiovascular magnetic resonance (CMR): Consensus Panel report?

“…Real-time CMR may be used to monitor wall motion and may eliminate the need for breath-holding. 197 Diastolic function has been shown to be abnormal using dobutamine CMR in CAD, 198,199 and parameters of global ventricular function such as flow acceleration are affected by dobutamine-induced ischaemia. 200 Further work is required to determine the clinical role of these techniques.…”

Leonardo da Vinci's flights of the mind must continue: cardiac architecture and the fundamental relation of form and function revisited

“…The lengthening of the ventricle after aortic valve closure and before opening of the mitral valve during which sonomicrometry suggests an initial phase of cocontraction of descending and ascending fibers of reciprocal oblique orientation, followed by relaxation of descending and continued shortening of ascending fibers, is postulated to contribute very importantly to the rapid early filling of the left ventricle. The elongation of the long axis of the LV with consequent upward displacement of the mitral valve plane has been well demonstrated by special MRI techniques (velocity mapping) and correlated with the onset of mitral diastolic flow by echocardiography and by magnetic resonance velocity mapping of mitral flow [45,85].…”

“…However, methods that depend on implantation of beads or devices into the left ventricular wall cannot sample multiple sites, could possibly interfere with myocardial deformation and can only be applied to a limited number of subjects under very special circumstances. Magnetic resonance imaging combined with MRI tissue tagging by selective radiofrequency saturation provides a unique nondestructive means of studying three-dimensional wall motion, deformation and strain in normal and diseased hearts [38][39][40][41][42][43][44][45][46][47].…”

Regional myocardial function in healthy adults: assessment through tissue Doppler echocardiography

“…the different ventricular zones were reported in experimental studies 49 and invasive methods 50 with off line and frame-by-frame analysis of ventriculographies, which, due to the complexity of the analysis and time consumption, has little clinical applicability. Of the noninvasive methods, the isotopic ones [51][52][53][54][55][56] (despite the deficient temporal resolution and the fact that they are not performed in real time), tagging magnetic resonance imaging [57][58][59][60] (with the disadvantages of having poor temporal resolution, of not being acquired in real time, of being expensive, and of being of difficult accessibility) and ultrafast computerized axial tomography stand out 61 . In regard to ultrasound methods, M-mode echocardiography [62][63][64][65][66] , despite its high temporal resolution, has the disadvantage of limiting the analysis to segments with movement parallel to the ultrasound beam, which is a limitation that can be potentially overcome with the "anatomic M-mode".…”