Assessment of regional left ventricular function during exercise test withpulsed tissue Doppler imaging

To investigate whether mitral annular velocity, measured by tissue Doppler imaging (TDI), is able to get a feasible quantitative evaluation of global and regional left ventricular function during exercise test, 29 patients wi th previous uncomplicated myocardial infarction were studied by exercise ec hocardiography. All patients underwent coronary arteriography within 10 day s of stress echocardiography. All of them were in sinus rhythm and had no r ight or left bundle branch block or significant mitral regurgitation as obs erved by left ventriculography. A total of 12 patients had anteroseptal and /or posteroseptal wall asynergies and left anterior descending involvement 9 patients had lateral and/or posteroinferior asynergies and left circumfle x coronary artery involvement; 8 patients had inferior and posteraseptal wa ll asynergies and right coronary artery involvement. Twelve subjects of sam e age and sex with normal cardiovascular findings were selected as a contro l group. TDI sample volumes were set on the mitral annuli corresponding to anteroseptal, posterior, posteroseptal, lateral, anterior, and inferior wal l in 4-chamber, 2-chamber, and long-axis views. There was a significant cor relation between the left-ventricular ejection fraction (0.41 +/- 0.8) and the means of the systolic (8) values (6.1 +/- 0.9 cm/sec, r = 0.83, p <0.01 ). The mean S at the sites corresponding to the infarct regions (5.5 +/- 0. 4 cm/sec) was significantly lower than the control group (11 +/- 0.8 cm/sec , p <0.001). After stress, in patients with multivessel disease, S values c orresponding to remote regions were significantly lower (p <0.01) compared with control subjects. Thus, the parameters obtained from mitral annular ve locities with pulsed TDI in patients with previous myocardial infarction re flect left ventricular asynergy corresponding to the infarct regions and re versible regional dysfunction after exercise. (C) 2000 by Excerpta Medica, Inc.