Regional wall motion assessment in stress echocardiography by tissue Doppler bull's-eyes

Quantification of regional myocardial wall velocities is needed In stress e chocardiography for transition from subjective to quantitative assessment. Tissue Doppler allows quantitation of wall velocities, but interpretation i s difficult and angle-dependent, Calculating the ratios of velocities with similar angles to the beam map overcome angle dependency. We measured left ventricular wall velocities during stress echocardiography with tissue Dopp ler. Regional peak systolic and early (E) and late (A) diastolic velocities were constructed in a "bull's-eye" format. Regional stress/rest and E/A ra tios were calculated. Bull's-eye map construction demanded only minimal man ual interaction, and the maps showed the left ventricular velocity distribu tion, simplifying wall motion reading markedly. Still, apical velocities ap peared lower as a result of Doppler angle-dependency. With velocity ratios, angle-dependency was no longer noted. In stress echocardiography, wall mot ion abnormalities at rest and contractility changes with dobutamine became readily apparent. Bull's-eye display of quantitative tissue Doppler velocit y allows rapid. assessment of regional wall motion. Calculating the ratio o f regional velocities circumvents the angle-dependency of Doppler. This nov el technique has the potential for simplified and automated quantitative an alysis in stress echocardiography.