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Updated: Aug 13, 2026
Primary Outcome Assessment in a Pig Model of Acute Myocardial Infarction
Published on: October 14, 2016
Changes in Doppler indices of cardiac function during and after percutaneous transluminal coronary angioplasty
A C Hunt1, S C Chow, J Escaned
1University Department of Cardiovascular Medicine, Queen Elizabeth Hospital, University of Birmingham.
Insights
Doppler indices like V2/T and MD are sensitive to cardiac function changes during myocardial ischemia caused by angioplasty. These measurements can help assess heart function during such procedures.
Area of Science:
- Cardiology
- Cardiovascular Physiology
- Diagnostic Imaging
Background:
- Myocardial ischemia during coronary angioplasty can impair global cardiac function.
- Assessing cardiac function changes in real-time during procedures is crucial for patient management.
Purpose of the Study:
- To evaluate the sensitivity of various Doppler indices to global cardiac function changes during induced myocardial ischemia.
- To determine the order of sensitivity among Doppler indices (V, MA, V2/T, MD) to ischemic events.
Main Methods:
- Continuous wave Doppler signals of aortic flow were recorded in 16 patients undergoing coronary angioplasty.
- Doppler indices including peak velocity (V), mean acceleration (MA), V2/T, and minute distance (MD) were measured before, during, and after balloon inflation.
- Patients with multivessel disease were specifically noted.
Main Results:
- 12 patients demonstrated a significant decrease (≥3 indices) in Doppler parameters during balloon inflation.
- Doppler indices showed substantial reductions: V2/T by 43.7%, MD by 37.7%, V by 27.4%, and MA by 23%.
- The relative sensitivity order was V2/T > MD > V > MA, with all changes being statistically significant (p < 0.0001).
Conclusions:
- Doppler indices V2/T, MD, V, and MA are sensitive indicators of global cardiac function decline during ischemia.
- These indices, particularly V2/T and MD, can be valuable for real-time cardiac function assessment in clinical settings during ischemic events.
- The observed impairment of cardiac function was reversible after reperfusion.
Objective:
To assess the sensitivities of Doppler indices to changes in global cardiac function during and after controlled myocardial ischaemia induced by coronary angioplasty.
Design:
Continuous wave Doppler signals of aortic flow were recorded during coronary angioplasty. The following Doppler indices of cardiac function were measured before, during, and after balloon inflation: V (peak velocity), MA (mean acceleration), V2/T (T = time from onset to peak ejection), and MD (minute distance corrected for baseline heart rate).
Setting:
A tertiary care cardiological unit in a university hospital.
Patients:
Sixteen patients undergoing coronary angioplasty of the left anterior descending coronary artery. Eight patients had multivessel disease.
Main Outcome Measures:
The primary outcome measures were planned before data collection began.
Results:
12 patients showed a significant fall of three or more Doppler indices from their baseline values during balloon inflation. This occurred in all patients with multivessel disease. The Doppler indices V2 T, MD, V, and MA fell by 43.7%, 37.7%, 27.4%, and 23% respectively from their baseline values (p less than 0.0001). The relative sensitivities of the Doppler indices to ischaemia were V2/T greater than MD (p less than 0.02), MD greater than (p less than 0.001), and V greater than MA (p less than 0.01). The impairment of global left ventricular function resulting from brief balloon inflation during single vessel angioplasty was reversible in all the patients.
Conclusions:
The Doppler indices V2/T, MD, V, and MA are all sensitive, in order of magnitude, to falls in global cardiac function resulting from ischaemia. They may prove useful for assessing cardiac function during ischaemia in the clinical setting.
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