Assessment of regional long-axis function during dobutamine echocardiography

Area of Science:

• Cardiology
• Echocardiography
• Physiology

Background:

• Regional left ventricular function is typically assessed by radial motion.
• Evaluating long-axis motion has been clinically challenging until recent advancements in tissue Doppler techniques.

Purpose of the Study:

• To compare standard visual assessment of radial wall motion with quantitative tissue Doppler measurements.
• To assess the correlation of tissue Doppler parameters with coronary artery disease (CAD) and myocardial ischemia during dobutamine stress echocardiography (DbE).

Main Methods:

• 104 patients with known or suspected CAD underwent dobutamine stress echocardiography (DbE).
• Quantitative tissue Doppler imaging assessed peak systolic velocity (PSV), time to peak velocity (TPV), and strain rate (SRI).
• Wall motion was visually assessed, and results were compared with coronary angiography and an angiographic score for jeopardized myocardium.

Main Results:

• Significant differences in PSV, TPV, and SRI were observed between normal and abnormal radial wall motion segments.
• Tissue Doppler parameters differed significantly between normally perfused segments and those with stenosed subtending coronary arteries.
• PSV, TPV, and SRI values varied significantly based on the extent of jeopardized myocardium, indicating correlation with ischemia.

Conclusions:

• Peak systolic velocity, timing of contraction, and strain rate (SRI) reflect underlying myocardial physiology during DbE.
• These quantitative tissue Doppler parameters offer objective analysis of regional wall motion and myocardial ischemia.
• Tissue Doppler imaging shows potential for improved clinical assessment of cardiac function in patients with coronary artery disease.