Regional diastolic function is more preserved in viable than non-viable myocardium. Demonstration by pulsed-wave Doppler tissue imaging in basal conditions

Introduction and objectives. The aim of this study was to analyze the diffe rences in regional diastolic function between viable and non-viable myocard ium when assessed by pulsed-wave Doppler tissue imaging performed in basal conditions. Patients and methods. The study population included 21 patients with three- vessel disease and regional systolic dysfunction. These patients underwent transthoracic echocardiographic study and pulsed-wave Doppler tissue imagin g in basal conditions and, in addition, stress echocardiography with dobuta mine performed by a different investigator. Results. Three-hundred and twenty-two segments were studied, 140 of which ( 43%) had systolic dysfunction. Of the 140 segments with systolic dysfunctio n, 52 (37%) were considered hypokinetic by transthoracic echocardiography, 80 (57%) akinetic and 8 (6%) dyskinetic. As assessed by dobutamine echocard iography, 67 segments (48%) were considered viable and 73 (52%) non-viable. Viable segments had a higher peak velocity of the early diastolic wave e ( 5.5 +/- 1.9 vs. 4.7 +/- 2.0 cm/s; p = 0.03). An e/a ratio < 1 was more freq uent in non-viable versus non-viable segments (52 vs. 70%; p < 0.05). There were no differences in relation to regional isovolumetric relaxation time and peak velocity of a wave. Although peak velocity of s wave was lower in non-viable segments, differences were not statistically significant. Conclusion. Compared with non-viable segments, viable myocardial segments h ave less impaired regional diastolic function as assessed by pulsed-wave Do ppler tissue imaging.