RESUMO
Objective To evaluate the distribution characteristics of left ventricular systolic dyssynchrony (LV-SD) in dilated cardiomyopathy (DCM) patients with chronic heart failure (CHF) and normal QRS wave width, by pulsed-wave Doppler tissue imaging (PW-DTI), and study its relation with left ventricular systolic function, ventricular remodeling, and functional mitral regurgitation (FMR). Methods The time to peak systolic velocity (Ts) in 12 left ventricular segments was evaluated by PW-DTI, from which the standard deviation (SD) of Ts in the 12 segments (Ts-SD) and maximum Ts difference (Ts-maxD) were calculated. Results Ts-SD and Ts-maxD in the 12 LV segments of the DCM patients with CHF were significantly higher than those of the healthy controls (P＜0.01). In DCM patients with CHF and normal QRS wave width, the incidence of LV-SD was 29.8% (14/47) and the inferior wall was the most frequent distribution site of contraction delay. Linear regression analysis revealed a negative correlation between Ts-SD, Ts-maxD, and left ventricular ejection fraction (LVEF) (P＜0.01), but a positive correlation between Ts-SD, Ts-maxD and left ventricular end-diastolic volume (LVEDV), lefe ventricular end-systolic volume (LVESV), New York Heart Association (NYHA) cardiac function, FMR (P＜0.01) in DCM patients with CHF. Conclusion LV-SD exists in DCM patients with normal QRS width. LV-SD aggravates the LV systolic function damage, which is closely associated with left ventricular remodeling. LV-SD may contribute to the FMR in DCM patients.
RESUMO
Objective: To assess the regional systolic and diastolic function of left ventricle before and after coronary stent implantation by pulsed wave Doppler tissue imaging (PW-DTI). Methods: Twenty-six patients with coronary artery disease ( CAD) involving only left anterior descending coronary artery ( LAD) were examined within 1-3 days before, 7 days and 30 days after coronary stenting with PW-DTI. Peak systolic , peak early diastolic, and peak late diastolic motion velocities ( Sm, Em, and Am respectively) were measured at 6 different sites on the basal and medial segments corresponding to the anteroseptal, postero-septal, lateral, anterior, inferior, and posterior walls of the left ventricle. Results:In corresponding segments depending on LAD blood flow supply, Sm was increased significantly 7 days after the stenting proce- dure. Em was also increased 7 days after the procedure in most of the corresponding segments. There were little changes in other segments that were independent on LAD blood flow supply. Conclusion: These findings suggest that there is an early improvement in the regional systolic and diastolic function of the left ventricle after the coronary stenting, and that PW-DTI techniques could evaluate quantitatively the regional ventricular performance in patients receiving percutaneous coronary intervention.