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Left ventricle dynamics during pulsus alternans: insights from tissue velocity imaging
Partho P Sengupta1, Jagdish C Mohan, Samanjay Mukherjee
1Department of Cardiology, GB Pant Hospital, New Delhi. ppsengupta@rediffmail.com
Indian Heart Journal
|September 10, 2002
Summary
Pulsus alternans in idiopathic dilated cardiomyopathy is linked to beat-to-beat changes in mitral annular tissue Doppler velocities during systole and diastole. These findings highlight altered myocardial function in this condition.
Area of Science:
- Cardiology
- Cardiovascular Physiology
- Echocardiography
Background:
- Idiopathic dilated cardiomyopathy (IDCM) is a significant cause of heart failure.
- Pulsus alternans, an alternating pattern of strong and weak heartbeats, can indicate severe left ventricular dysfunction.
Observation:
- A 34-year-old female patient with IDCM presented with clinical signs of pulsus alternans.
- Echocardiographic assessment using tissue Doppler imaging was performed to evaluate myocardial mechanics.
Findings:
- Mitral annular tissue Doppler velocities exhibited reciprocal beat-to-beat variations during both systolic ejection and diastolic filling phases.
- These alterations in tissue velocity waves were specifically observed during the dynamic phases of the cardiac cycle.
Implications:
- The findings suggest that pulsus alternans in IDCM is associated with specific patterns of altered myocardial contractility and relaxation.
- Tissue Doppler imaging can provide valuable insights into the beat-to-beat mechanical dysfunction characteristic of advanced dilated cardiomyopathy.