COMPARISON OF MYOCARDIAL VELOCITIES BY CO LOR DOPPLER TISSUE IMAGING IN NORMAL SUBJECTS AND IN DILATED CARDIOMYOPATHY

The authors studied 35 normal subjects (41 +/- 6 years) and 22 patient s with idiopathic dilated cardiomyopathy 48 +/- 7 years; ejection frac tion : 31 +/- 12 %) in order to determine normal values of myocardial velocities and to demonstrate the sensitivity of Doppler tissue imagin g in detecting a significant decrease in myocardial velocities in pati ents with abnormal left ventricular contractility. Interventricular se ptal and left ventricular posterior wall velocities were recorded by M mode long axis parasternal views. In normal subjects, a velocity grad ient in the posterior wall was observed, higher in the endocardium tha n in epicardium, in systole (5.1 +/- 1.5 versus 2.8 +/- 1 cm/s, p < 0. 01), and early diastole (13.7 +/- 3.5 versus 5.7 +/- 2 cm/s, p < 0.001 ) and late diastole at the time of atrial contraction (2.7 +/- 2.1 ver sus 1.8 +/- 1.7 cm/s, p < 0.01). Moreover, the Velocities are higher i n the posterior wall than in the interventricular septum throughout th e cardiac cycle. Finally, the velocities are higher in early diastole than in systole, both in the interventricular septum and posterior wal l. In the group of patients with idiopathic dilated cardiomyopathy, th e intramyocardial velocities were lower than in normal subjects. In ad dition, the velocity gradient in the posterior wall was absent in 15 o f the 22 patients. The authors conclude that Doppler tissue imaging pr ovides new information in the analysis of myocardial function both in systole and diastole.