ABSTRACT
AIM: Myocardial ischemia impairs the diastolic left ventricular (LV) function earlier than the systolic function. We evaluated the value of pulse-wave Doppler Tissue Imaging (DTI) in the study of regional myocardial function of LV in patients with coronary artery disease. METHODS: 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. RESULTS: We have demonstrated that compared with healthy subjects, patients with coronary artery disease has a significant increase of IVRT (100.2 +/- 20 ms vs 62.5 +/- 12.2, p <0.001) and lower Ea (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 more 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 CONCLUSION: The pulsed DTI technique seems to be attractive as a non-invasive evaluation method of ischemic heart disease.
