TISSUE DOPPLER-ECHOCARDIOGRAPHY - A NEW METHOD OF EVALUATING PERFUSION-DEPENDENT MYOCARDIAL-FUNCTION DURING PTCA

The increasing demand for insight into the relationship between corona ry perfusion and myocardial function stimulated the development of tis sue Doppler echocardiography. This new technique was applied simultane ously with PTCA of a subtotal LAD lesion (single vessel disease, no co llaterals) in a 68-year-old patient suffering from unstable angina pec toris. Prior to the conventional signs of ischaemia a decrease in myoc ardial tissue velocities and a loss of color-coded heart cycle interva ls was observed. A myocardial velocity gradient calculated from the hi gher subendocardial and lower subepicardial velocity decreased from 3. 3 to 1.3. This decrease was prevented by an active autohaemoperfusion device which supplied blood distally to an insufflated balloon (60 ml/ min). Thus, contractility and viability might be maintained by preserv ing myocardial velocity gradients.