QUANTITATIVE-EVALUATION OF GLOBAL AND REGIONAL LEFT-VENTRICULAR DIASTOLIC FUNCTION WITH COLOR KINESIS

Background-Diastolic wall motion asynchrony is a major determinant of impaired left ventricular (LV) filling in patients with concentric hyp ertrophy and coronary artery disease. We evaluated the ability of Colo r Kinesis, a new echocardiographic technique that color-encodes endoca rdial motion, to quantitatively assess global and regional LV filling properties. Methods and Results-Color Kinesis images and mitral and pu lmonary vein now Doppler data were acquired in 29 patients with LV hyp ertrophy and 29 age-matched control subjects. In addition, Color Kines is data were correlated to coronary angiographic findings in 15 patien ts with suspected coronary artery disease. Segmental analysis of Color Kinesis images was used to obtain time histograms of regional diastol ic fractional area change, wherein early and late peaks (peaks 1 and 2 ) reflected rapid LV filling and atrial contraction, respectively. Reg ional mean LV filling time and filling curves were used to objectively identify diastolic endocardial motion asynchrony in patients with LV hypertrophy and coronary artery disease. None of the mitral and pulmon ary vein Doppler indices differentiated patients with normalized mitra l Doppler profile (n=13) from control subjects, whereas reduced peak1/ peak2 ratio and prolonged mean filling time indicated augmented contri bution of atrial contraction toward LV filling (P<.05). In 22 of 25 pa tients with LV hypertrophy and preserved systolic function and in all patients with coronary artery disease, delayed diastolic endocardial m otion was observed in at least one segment. Conclusions-Analysis of Co lor Kinesis images provides objective assessment of global and regiona l LV filling properties and allows identification of both diastolic dy sfunction in patients with normalized Doppler indices and wall motion asynchrony.