Vol. 8, No 1, 2001 pp. 31 - 34
UC 616.072
DETECTION OF VIABLE MYOCARDIUM DURING
DOBUTAMINE ECHOCARDIOGRAPHY USING DOPPLER MYOCARDIAL IMAGING
IN PATIENTS WITH RECENT MYOCARDIAL INFARCTION
Marina Ž. Deljanin Ilić, Stevan N. Ilić, Branko K. Lović
Institute of Cardiology, Niška Banja, University of Niš, Yugoslavia
e-mail: marinadi@bankerinter.net
Summary. The aim of this study was a quantitative assessment of
regional systolic and diastolic myocardial velocity in basal condition
and during dobutaimine echocardiography in viable and in non-viable myocardial
segments using pulsed wave Doppler myocardial imaging (PW-DMI).
In the group of 34 patients, 13+3 days after acute myocardial infarction
low dose dobutamine echocardiography (LDDE) was performed. Viability was
defined as an improvement of wall motion during LDDE in dyssynergic left
ventricular segment. Before and after LDDE wall motion score (WMS) was
calculated. Apical views were used to assess myocardial velocity at baseline
and after LDDE. In each of 11 left ventricular segments, peak early (E)
and late (A) diastolic velocities and systolic (S) velocity were measured
and ratio E/A was calculated.
At baseline echocardiography 122 (32.6%) left ventricle segments were
dyssynergic. During LDDE 51 (41.8%) viable myocardial segments in 16 (47%)
patients were detected, while 71 segments were non-viable. In patients
with viable myocardial segments WMS decreased significantly (P<0.001)
after LDDE.
Baseline values of E and S myocardial velocities and E/A ratio were
significantly higher (P<0.005 and P<0.01 and P<0.001) in viable
compared to non-viable myocardial segments. Viability by PW-DMI sampling
at LDDE corresponded with an significant improvement of E (P<0.01),
S (P<0.005) velocities and E/A ratio (P<0.05) compared to the baseline
values.
In conclusion, PW-DMI allows quantitative assessment of regional systolic
and diastolic myocardial velocities and detection of viable myocardium
in basal condition and during LDDE.
Key words: Viable myocardium, Doppler myocardial imaging, dobutamine
echocardiography, recent myocardial infarction
DETEKCIJA VIABILNOG MIOKARDA TOKOM DOBUTAMIN
EHOKARDIOGRAFSKOG TESTA PRIMENOM MIOKARDNOG DOPPLERA
U BOLESNIKA SA SKORAŠNJIM INFARKTOM MIOKARDA
Kratak sadržaj: Cilj studije bio je kvantitativna procena regionalnih
sistolnih i dijastolnih brzina miokarda u bazalnim uslovima i tokom dobutamin
ehokardiografskog testa u viabilnim (živo miokardno tkivo) i neviabilnim
segmentima miokarda leve komore primenom pulsnog miokardnog Dopplera (PW-DMI).
Grupi od 34 bolesnika, 13+3 dana posle akutnog infarkta miokarda uradjen
je ehokardiografski test primenom malih doza dobutamina (LDDE). Viabilnost
miokarda definisana je kao popravljanje regionalne zidne pokretljivosti
tokom LDDE u segmentima leve komore koji su u bazalnim uslovima ispoljili
disinergiju. Pre i posle LDDE izračunavan je skor zidne pokretljivosti
(WMS). Miokardne brzine odredjivane su pre i posle LDDE iz apikalnih preseka
leve komore. U svakom od 11 segmenata leve komore, merena je maksimalna
sistolna (S) brzina, rana (E) i kasna (A) dijastolna brzina miokarda i
izračunavan odnos E/A. Ehokardiografskim pregledom u bazalnim uslovima
registrovana je disinergija u 122 (32,6%) segmenta leve komore. Tokom LDDE
51 (41,8%) segment kod 16 (47%) bolesnika ispoljio je viabilnost, dok je
71 segment bio neviabilan. Posle LDDE, u bolesnika sa viabilnim segmentima
miokarda leve komore registrovano je značajno smanjenje WMS (P<0,001).
Bazalne vrednosti miokardnih brzina E i S i odnosa E/A bile su značajno
veće (P<0,005; P<0,01 i 0,001) u viabilnim u poredjenju sa
neviabilnim segmentima miokarda. Odredjeno parametrima PW-DMI, tokom LDDE,
prisustvo viabilnog miokarda karakteriše značajno povećanje E (P<0,01),
S (P<0,005) miokardnih brzina i odnosa E/A (P<0,05) u poredjenju
sa bazalnim vrednostima.
Naša studija je pokazala da primena PW-DMI pruža mogućnost kvantitativne
procene regionalnih sistolnih i dijastolnih miokardnih brzina, a time i
otkrivanje viabilnog miokarda kako u bazalnim uslovima, tako i tokom LDDE.
Ključne reči: Viabilni miokard, miokardni Doppler, dobutamin
ehokardiografija, skorašnji infarkt miokarda
