Myocardial architecture, texture and left ventricular heterogeneity in the pulsed Doppler tissue imaging pattern

The regional contribution for the global ventricular functional performance is complex and heterogeneous, the myocardial texture could reflect this particular aspect, during the phases of myocardial contraction and relaxation. The objective of our clinical study was to evaluate the relationship between the segmental myocardial velocity pattern by Doppler tissue imaging and the ultrasound characteristics of the left ventricular myocardium analysed by computerized ultrasound densitometry with the calculation of its intensity (dB), in a population of 22 subjects without clinical history of cardiovascular pathology, 50% female gender, mean age 43 +/- 11 years (19-66 years). In the methodology of study, the left ventricular myocardium was divided in 16 segments, according with the transthoracic echocardiographic recommendations of the American Society of Echocardiography (A.S.E.). During one cardiac cycle interval, the ultrasound characteristics of the left ventricular myocardium were evaluated continuously and in a quantitative manner, applying the computerized ultrasound densitometry method on the gray scale images of the ventricular myocardium, with the sample size identical to the myocardial wall thickness. The peak (Vmax-cm/sec) and mean (Vm-cm/sec) pulsed Doppler tissue imaging velocities, individuals, segmental and a total velocities, contraction and relaxation velocities of the left ventricular myocardium were obtained immediately after the computerized ultrasound densitometry analysis. Ultrasound densitometry and Doppler tissue imaging data were obtained in a total number of 352 left ventricular myocardial segments. Using the multiple linear correlation matrix analysis, the ultrasound intensity registered inverse significant correlation's with the Doppler tissue imaging Vmax and Vm for the systolic "s" wave in the total segments and each one of them (r = -0.66; p = 0.001; interval 2-18 cm/sec; r = -0.52 to -0.70) and with the early diastolic "e" wave (r = -0.42; p = 0.01; interval 2-19 cm/sec; r = -0.35 to -0.55). Direct correlation's were obtained for the computerized ultrasound densitometry intensity and Doppler tissue imaging Vmax and Vm of the late diastolic "a" wave in the total number of the left ventricular myocardial wall segments and in each one of them (r = 0.51; p = 0.01; interval 1-17 cm/sec; r = 0.42 a 0.66). We conclude that in our study and under physiological conditions of myocardial performance, a direct correlation was obtained between the ultrasound characteristics of the ventricular myocardial imaging and its velocities of contraction and relaxation. These facts reflect the close relationship between left ventricular myocardial structure and function, analyzed by the new ultrasound Doppler technologies.