[Pluse wave doppler tissue imaging in the assessment of regional left ventricular diastolic function in patients with coronary artery disease]

ABSTRACT

Myocardial ischemia impairs the diastolic left ventricular [LVi function earlier than the systolic function. We evaluated the value of pulse-wave Doppler Tissue Imaging [DTI] in the study of regiona myocardial function of LV in patients with coronary artery disease. We performed a prospective study in 60 patients with coronary artery disease that we compared to 40 healthy individuals in order to assess the value of pulse-wave DTI to study the diastolic LV function. Both groups had a clinical examination, ECG echocardiography and pulse-wave DTI. Only the patients had a coronary angiography. Pulse-wave DTI was applied to the 16 myocardial segments of the LV, we measured the isovolumetric relaxation time [IVRT], early [Ea] and late diastolic [Aa] velocities We have demonstrated that compared with healthy subject patients with coronary artery disease has a significant increase of IVRT [100.2 +/- 20ms vs 62.5 +/- 12.2, p <0.001] and lower Ba [7.6 +/- 1.6 vs. 9.2 +/- 2.6] and report Ea/Aa. These anomalies are more pronounced in akinetic segments compared with hypokinetic segments. Relying on data from the coronary angiography, we found in patients that IVRT had increased, Ea and Ea/Aa lowered in most segments hypoperfused than in normally perfused segments. An IVRT>70ms and Ea <8.3 cm/s emerge as threshold values to identify myocardial ischemia. More coronary lesions are severe mom Ea and Ea/Aa decline and IVRT increase. The culprit coronary artery could be identified by pulse-wave DTI since the DTI parameter anomalies are systemized. The pulsed DTI technique seems to be attractive as a non-invasive evaluation method of ischemic heart disease