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[Systolic and diastolic left ventricle function assessment by tissue Doppler echocardiography in patients with
Magdalena Kostkiewicz1, Wojciech Płazak, Wiesława Tracz
1Klinika Chorób Serca i Naczyń, Collegium Medicum, Uniwersytetu Jagiellońskiego w Krakowie.
Insights
Tissue Doppler imaging (TDI) and SPECT reveal that reduced systolic and diastolic function correlate with fixed perfusion defects in ischemic heart disease. Diastolic dysfunction also appears in patients with exercise-induced perfusion defects.
Area of Science:
- Cardiology
- Nuclear Medicine
- Diagnostic Imaging
Background:
- Tissue Doppler imaging (TDI) quantifies regional left ventricle systolic and diastolic function.
- Heart scintigraphy (SPECT) assesses myocardial perfusion.
- Ischemic heart disease (IHD) impacts both cardiac function and perfusion.
Purpose of the Study:
- To evaluate the correlation between myocardial perfusion defects (SPECT) and regional left ventricle function (TDI) in IHD patients.
- To identify functional changes associated with different perfusion defect patterns.
Main Methods:
- 40 IHD patients underwent rest TDI and rest/exercise Tc99 MIBI SPECT.
- Systolic and diastolic myocardial velocities were assessed in 13 left ventricle segments.
- Patients were categorized into groups based on SPECT findings: fixed defects, exercise-induced defects, or normal perfusion.
Main Results:
- Significantly lower systolic and diastolic velocities were observed in segments with fixed perfusion defects (Group I) compared to other groups.
- Segments supplied by LAD and Cx arteries showed reduced velocities in Group I.
- Diastolic velocities were lower in Group II (exercise-induced defects) compared to Group III (normal perfusion) in Cx-supplied regions.
Conclusions:
- Fixed myocardial perfusion defects are associated with significantly decreased systolic and diastolic myocardial velocities.
- Reduced diastolic velocity in TDI can indicate dysfunction even with normal rest perfusion but exercise-induced defects.
- TDI and SPECT provide complementary information for assessing IHD severity and impact on cardiac function.
Introduction:
Tissue Doppler imaging (TDI) facilitates the quantitative assessment of the regional systolic and diastolic left ventricle function. Heart scintigraphy (SPECT) facilitates the assessment of regional perfusion of the myocardium. The aim of the study was the evaluation of the correlation between the regional myocardial perfusion defects observed in the SPECT study and the regional systolic and diastolic left ventricle function observed in TDI examination in the ischaemic heart disease patients.
Material And Methods:
In 40 patients (33 men and 7 women) aged 43-74 years (mean age 56 years) diagnosed of ischaemic heart disease on the basis of coronary angiography, rest TDI examination was performed. Maximal systolic and maximal early-diastolic myocardial velocities were assessed in 13 myocardial segments of the left ventricle, supplied by respective coronary arteries (left anterior descending artery--LAD, circumflex artery--Cx, right coronary artery--RCA). During rest and exercise perfusion scintigraphy of the heart (Tc99 MIBI SPECT) myocardial perfusion was evaluated in the segments analysed previously during TDI study. On the basis of the SPECT examination results the patients were divided into three groups: group I) patients with fixed perfusion defects, group II) patients with exercise-induced perfusion defects and normal rest perfusion, group III) patients with normal perfusion during rest and exercise.
Results:
Systolic and diastolic myocardial velocity in LAD and Cx supplied segments were significantly higher in group II and group III as compared with group I. Systolic and diastolic velocities of myocardium supplied by LAD were significantly lower in group II as compared with group III. In Cx supplied region the diastolic myocardial velocity was significantly lower in group II as compared with group Ill.
Conclusions:
In the left ventricle myocardial regions with fixed perfusion defects, statistically significant decrease of systolic and diastolic myocardial velocities was observed. Moreover, the decrease of diastolic myocardial velocity in the rest TDI examination was found in patients with normal rest perfusion and exercise-induced perfusion defects.
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