Doppler myocardial imaging in the assessment of normal and ischemic myocardial function - past, present and future

Myocardial ischemia is associated with impaired regional myocardial functio n. Echocardiography is a suitable technique for the assessment of regional myocardial function as it is easily applicable and commonly available. Howe ver, most of the currently used echo-techniques are based on 2D images or M -mode traces. Therefore, they are limited either to the assessment of myoca rdial segments that can be insonated at 90 degrees or are based on visually assessed wall motion scoring which is semiquantitative at best. Doppler my ocardial imaging (DMI) is a new ultrasound technique which assesses the vel ocity of myocardial motion. Different parameters can be derived from this v elocity information such as velocity time integrals, intramural velocity gr adients and strain/strain-rate information. Moreover, DMI provides informat ion of the timing of regional motion related to myocardial contraction and relaxation. These parameters are all assessed quantitatively, therefore, DM I is a promising technique to quantify myocardial function, avoiding the di sadvantages of observer-dependant judgement of myocardial contraction.