Author + information
- Received November 3, 1994
- Revision received February 24, 1995
- Accepted March 2, 1995
- Published online July 1, 1995.
- Masaaki Uematsu, MD, PhDa,*,
- Kunio Miyatake, MD, PhD, FACCa,*,
- Norio Tanaka, BSa,*,
- Hisao Matsuda, MD, PhDa,
- Akihiro Sano, MSa,†,
- Nobuo Yamazaki, BSa,†,
- Makoto Hirama, PhDa,† and
- Masakazu Yamagishi, MD, PhD, FACCa,*
- ↵*Address for correspondence: Dr. Masaaki Uematsu, Department of Cardiovascular Dynamics, National Cardiovascular Center Research Institute. 5-7-1 Fujishiro-dai, Suita. Osaka 565, Japan.
Objectives. This study was performed to assess a new indicator of regional left ventricular contraction determined by a two-dimensional tissue Doppler imaging technique.
Background. Recent studies have demonstrated that instantaneous tissue motion velocity can be noninvasively assessed by tissue Doppler imaging. However, quantitative assessment of regional left ventricular contraction is still difficult because of the effects of the Doppler angle of incidence and parallel motion of the whole heart.
Methods. We assessed left ventricular wall motion in 11 normal subjects, 14 patients with an old myocardial infarction (anteroseptal in 7, posterior in 7) and 8 patients with dilated cardiomyopathy. Tissue Doppler velocity was corrected by the Doppler angle of incidence after the hypothetical center of contraction was set. Subsequently, the myocardial velocity gradient between the endocardium and epicardium was determined from the velocity profile along each radial line from the center of contraction by using least squares linear regression.
Results. In normal subjects, peak myocardial velocity gradient was lower in the anteroseptal wall (mean [±SD] 1.69 ± 0.53 s−1) than in the posterior wall (3.28 ± 0.67 s−1, p < 0.01). Myocardial velocity gradient in the infarct regions was significantly lower (anteroseptal 0.58 ± 0.41 s−1, p < 0.05; posterior 0.17 ± 0.27 s−1, p < 0.01) than that in normal subjects as well as that in the corresponding noninfarct regions (2.84 ± 0.37 s−1and 1.48 ± 0.25 s−1, p < 0.01, respectively). In patients with dilated cardiomyopathy, myocardial velocity gradient was generally lower (anteroseptal 0.72 ± 0.59 s−1posterior 0.93 ± 0.67 s−1) than that in normal subjects (p < 0.01).
Conclusions. These results demonstrate that regional left ventricular contraction can be quantitatively assessed by the myocardial velocity gradient derived from two-dimensional tissue Doppler imaging. We suggest that myocardial velocity gradient has potential for the quantitative assessment of regional left ventricular contraction abnormalities in patients.
This study was presented in part at the 67th Annual Scientific Sessions of the American Heart Association. Dallas, Texas, November 1994. It was supported in part by a Research Grant for Cardiovascular Disease (5A-3) from the Ministry of Health and Welfare of Japan, Tokyo, Japan.
- Received November 3, 1994.
- Revision received February 24, 1995.
- Accepted March 2, 1995.
- The American College of Cardiology