Vol.6, No 1, 1999 pp. 59 - 62
UC 612.17;616-072 
ALTERNATIONS IN INTRAVENTRICULAR FILLING PATTERN BY COLOR DOPPLER M-MODE DURING INDUCED MYOCARDIAL ISCHEMIA
Bojan Stojnić, Biljana Ćirić, Branko Gligić
Clinic of Cardiology, Military Medical Academy, Belgrade, Yugoslavia
Summary. It has been shown that regional myocardial ischemia during angioplasty is associated with retarded apical filling. To test the importance of retarded apical filling by color Doppler M-mode to detect ischemia during dipyridamole (DIP)stress echo we evaluated 29 patients (pts) (12 females, age 57+/-8 years).The high dose DIP (0.84 mg/kg over 10 min) was used. The color M - mode record was used to calculate the duration of abnormal apical flow as measured from the onset of the QRS complex to the disappearance of color signals directed toward the apex. Echocardiographic images were compared at rest and during stress to identify the presence of new or worsening wall motion abnormalities (WMA). Fourtheen pts (group A) were designated as having coronary artery disease on the basis on WMA during the stress test and abnormal coronary anatomy. Fifteen pts (group B) without WMA in the presence of normal coronary anatomy were designated as having no coronary artery disease.
All but two pts in group A developed an abnormal apical filling response to DIP stress (sensitivity 86%). In these pts the marked retardation of apical filling was detected during the ischemia (55+/-18 ms v 120+/-34 ms) (p<0.01).In Group B there were no dynamics in apical filling (specificity 100%).
Color M - mode Doppler imaging revealed retarded apical filling during DIP induced myocardial ischemia. This abnormal filling pattern may be a useful adjunct to WMA during DIP stress echo.
Key words: Color doppler echocardiography, myocardial ischemia, dipyridamole
PROMENE U INTRAVENTRIKULARNOM PUNJENJU LEVE KOMORE POMOĆU KOLOR M-MOD DOPPLER TEHNIKE U TOKU IZAZVANE ISHEMIJE MIOKARDA

Kratak sadržaj: Opisano je da u toku ishemije izazvane koronarnom angioplastikom dolazi do kasnijeg punjenja vrha leve komore. U radu smo ispitivali značaj kasnijeg punjenja vrha leve komore pomoću kolor Doppler M-mod tehnike u otkrivanju ishemije miokarda izazvane dipiridamolom (Dip). Ispitivano je 29 bolesnika (12 žena i 17 muškaraca, prosečne starosti 57+/-8 godina). Date su visoke doze Dip (0.84mg/kgtt u toku 10 minuta). Kolor M-mod Doppler tehnika je korišćena da bi se izračunalo trajanje apikalnog punjenja koje se izračunavalo od početka QRS kompleska do završetka apikalnog protoka. Dvodimenzionalnom ehokardiografijom je analizirana globalna i regionalna kontraktilnost leve komore u mirovanju i u toku stres testa. Grupa A se sastojala od 14 bolesnika koji su imali pozitivan stres test i koronarnu arterijsku bolest. Ispitanici druge grupe B (15 ispitanika) nisu imali koronarnu arterijsku bolest i stres test je bio negativan.
Svi, osim dva bolesnika grupe A, su imali kasnije punjenje vrha leve komore za vreme Dip stres testa (senzitivnost 86%). U ovih bolesnika značajno je kasnilo punjenje vrha srca u toku ishemije u odnosu na bazalne vrednosti (55+/-18 ms vs 120+/-34 ms) (p<0.01). U grupi B nije bilo dinamike u apikalnom punjenju (specifičnost 100%).
Kolor M-Mod Doppler tehnikom je dokazano kasnije apikalno punjenje za vreme ishemije miokarda izazvane Dip. Ovaj poremećaj u intraventrikularnom punjenju leve komore je korisna dopuna u analizi regionalne pokretljivosti zidova leve komore u toku Dip izazvane ishemije miokarda.
Ključne reči: Kolor dopler ehokardiografija, ishemija miokarda, dipiridamol