Quantitative Assessment of Alterations in Regional Left Ventricular Contractility With Color-Coded Tissue Doppler Echocardiography

Author:

Gorcsan John1,Strum David P.1,Mandarino William A.1,Gulati Vijay K.1,Pinsky Michael R.1

Affiliation:

1. From the Divisions of Cardiology (J.G., W.A.M., V.K.G.) and Anesthesiology and Critical Care Medicine (D.P.S., M.R.P.), University of Pittsburgh (Pa).

Abstract

Background Tissue Doppler imaging (TDI) is a novel method of color-coding myocardial velocity on-line. The objective of the present study was to evaluate endocardial velocity with TDI as a method of objectively quantifying alterations in regional contractility over a wide range induced by inotropic modulation. Methods and Results Myocardial length crystals were used to simultaneously assess regional left ventricular (LV) function, and high-fidelity pressure and conductance catheters were used to assess global LV contractility by pressure-volume relations in nine open-chest dogs. Mid-LV M-mode and two-dimensional color TDI images were recorded during control and inotropic modulation stages with dobutamine and esmolol. Predicted significant increases in TDI indices occurred with dobutamine: peak systolic velocity of 4.41±1.07 to 6.67±1.07 cm/s*, systolic time-velocity integral (TVI) of 0.43±0.12 to 0.62±0.10 cm*, and diastolic TVI of 0.49±0.11 to 0.71±0.17 cm*. Opposing significant decreases occurred with esmolol: peak systolic velocity of 4.46±0.94 to 2.31±0.81 cm/s*, systolic TVI of 0.47±0.12 to 0.19±0.11 cm*, and diastolic TVI of 0.55±0.11 to 0.33±0.11 cm* (*all P <.001 versus control). Changes in TDI peak systolic velocity were correlated with changes in fractional shortening ( r =.88) and shortening velocity ( r =.87) by sonomicrometry. Changes in TDI peak velocity from multiple mid-LV sites also correlated significantly with maximal elastance ( r =.85±.04) from pressure-volume relations. Conclusions TDI measures reflect directional and incremental alterations in regional and global LV contractility and have the potential to quantify regional LV function.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Physiology (medical),Cardiology and Cardiovascular Medicine

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