DOPPLER TISSUE IMAGING OF PRE-EJECTIONAL LEFT-VENTRICULAR WALL DYNAMICS IN A NORMAL SUBJECTS

Pre-ejectional left ventricular wall motion has been demonstrated clin ically by angiography. Intramyocardial wall velocities generated by ca rdiac contraction may be measured by Doppler tissue imaging. The aim o f this study was to detect pre-ejectional wall motion and to analyse i ts sequencer. A long axis M Mode with simultaneous septal and posterio r wall imaging was performed in 11 normal subjects (age 37 +/- 15 year s) with velocity analysis between the electrocardiographic Q wave and the onset of ejection by digitised analysis between the electrocardiog raphic Q wave and the onset of ejection by digitised images with autom atic velocity extraction (3.8 ms) along a horizontal subendocardial li ne. The total duration of the pre-ejectional periods in conventional a nd Doppler tissue imaging are compared. Oscillatory velocimetric apear ances with alternate colours of adjacent bands in each wall and a mirr or image between walls was observed. The mean and peak velocities of t he first four bands were significantly different between the walls (p < 0.001) as were the absolute Values between bands 2 (p < 0.02) and 3 (p < 0.006).The duration of band 2, related to motion mainly towards t he center of the ventricular chamber exceeded that of the adjacent ban ds (septum p < 0.02, posterior wall p < 0.001). The correlation coeffi cient for total duration of the pre-ejectional period between Doppler tissue imaging and conventional Doppler was 0.83, p < 0.05 for the int erventricular septum and 0.76, p < 0.04 for the posterior was. The aut hors conclude that regional pre-ejectional wall motion can be recorded . During isovolumic contraction, there is motion predominantly towards the center of the left ventricular chamber of the two walls, confirmi ng previous angiographic findings. its timing suggests that wall motio n precedes the increase in ventricular pressure.