PREEJECTIONAL LEFT-VENTRICULAR WALL-MOTION IN NORMAL SUBJECTS USING DOPPLER TISSUE IMAGING AND CORRELATION WITH EJECTION FRACTION

Relations have been demonstrated between the preelection period (PEP) and indexes of left ventricular (LV) systolic function. Doppler tissue M-mode imaging has the capability to measure wall velocities and to d isplay as colored strips within the walls velocity reversals represent ing changes in direction of wall motion. To document LV preejectional wall motions, this procedure was performed on 16 normal subjects with a twofold purpose: to measure septal and posterior preejectional intra myocardial velocities and durations and to correlate preejectional par ameters with LV ejection fraction (LVEF). Parasternal M-mode images of simultaneously recorded walls were digitized. Subendocardial wall vel ocities were measured every 3.8 ms from the Q wave to the onset of ele ction. Total duration measured from Doppler tissue and flow traces was compared in 10 subjects. PEP total duration did not differ between bo th walls or techniques. Several adjacent velocity reversals with mirro r signs in opposite walls were substantiated by 2 to 5 colored strips. Colored strips corresponding to the same sign I in each wall had a pr ogressively damped velocity amplitude (septum 19 +/- 8, -21 +/- 10, 15 +/- 7, -8 +/- 5, 4 +/- 2 mm/s; posterior wall -13 +/- 16, 11 +/- 7, - 8 +/- 5, 9 +/- 6, -2 mm/s). Peak velocity values of opposite signs sig nificantly differed between both walls (p <0.0001), Absolute values di ffered only for colored strips 2 and 3 (p <0.009). Strip 2 featured a simultaneous early inward motion of both walls toward the LV cavity wi th significantly prolonged duration (p <0.0001). The only positive cor relation with LVEF was found for peak velocities of strip 2 in the pos terior wall (r = 0.71, p <0.006). Thus, the posterior wall and its inw ard motion velocities have potential for future clinical implications. (C) 1997 by Excerpta Medica, Inc.