Analysis of systolic and diastolic time intervals during dobutamine-atropine stress echocardiography: Diagnostic potential of the Doppler myocardial performance index

Systolic and especially diastolic Doppler time intervals may be early marke rs of myocardial ischemia inducible by dobutamine-atropine stress echocardi ography (DASE). We postulated that the Doppler myocardial performance index (MPI) may help differentiate ischemic from nonischemic responses. Hemodyna mic and Doppler echocardiography variables were measured prospectively at e very stress level of DASE in 32 patients (mean age 67 +/- 13 years). Adequa te recordings were obtained in 27 patients; 13 had an ischemic response (gr oup 1) and 14 a nonischemic response (group II). Heart rate differed betwee n groups at baseline. At equivalent peak stress, left ventricular wall moti on score index was significantly greater and ejection fraction lower in gro up I patients. Of the Doppler variables, only the MPI consistently differed between groups, irrespective of the number of stress levels compared. The Doppler MPI may be a useful adjunct to wall motion analysis in the detectio n of myocardial ischemia during DASE.