Analysis and quantification of longitudinal left ventricular contraction in myocardial infarction: Value of Doppler tissue imaging

The authors compared the results of conventional 2D echocardiography and th ose of Doppler tissue imaging in 30 patients in the intensive care unit for acute pulmonary myocardial infarction and 10 normal control subjects, to a ssess the longitudinal contraction of the left ventricle. Echocardiography was performed in the apical 2 and 4 chamber views to analyse the septal, la teral, posterior and anterior left ventricular walls. Each wall was divided into 3 segments : basal, median and apical. Each segment was scored : 1 - normo or hyperkinetic, 2 - hypokinetic, 3 - akinetic and 4 - dyskinetic. Do ppler tissue imaging provided the maximum instantaneous velocities in systo le and diastole in each segment. In control subjects, the myocardial velocities decreased significantly from the base to the apex, resulting in a systolic and diastolic pressure gradi ent with each wall between the base and the apex. In patients with myocardi al infarction, the myocardial velocities were decreased compared with the c ontrol group. Moreover, the myocardial velocity gradient between the base a nd apex was significantly reduced in the hypo and akinetic walls, both in s ystole and diastole. These results show that, in myocardial infarction, the longitudinal left ve ntricular contraction is abnormal and may be analysed and quantified by new indices of myocardial systolic and diastolic function, provided by Doppler tissue imaging.