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Updated: May 23, 2026
Ultrasonic Assessment of Myocardial Microstructure
Published on: January 14, 2014
Detection of wall motion abnormalities during ambulatory echocardiography using a novel ultrasound transducer
Premindra Anthony N Chandraratna1, Dilbahar S Mohar, Peter F Sidarous
1Division of Cardiology, Long Beach VA Medical Center, UC Irvine School of Medicine, Long Beach, California, USA. echodop@gmail.com
Insights
Ambulatory echocardiography detected transient wall motion abnormalities in patients with coronary artery disease (CAD) during walking-induced myocardial ischemia. This portable technique shows promise for evaluating ischemia in selected patients.
Area of Science:
- Cardiology
- Medical Imaging
- Diagnostic Techniques
Background:
- Transient myocardial ischemia can cause temporary abnormalities in heart wall motion.
- Detecting these abnormalities during physical exertion is crucial for diagnosing coronary artery disease (CAD).
- Ambulatory echocardiography offers a portable solution for assessing cardiac function outside a clinical setting.
Purpose of the Study:
- To evaluate the efficacy of ambulatory echocardiography in detecting transient wall motion abnormalities.
- To assess myocardial ischemia induced by walking in patients with and without CAD.
- To determine the potential utility of this technique in clinical practice.
Main Methods:
- Two groups were studied: healthy males (Group 1) and patients with diagnosed CAD (Group 2).
- A portable echocardiography system with a steerable transducer was used.
- Subjects underwent a 10-minute walking test, during which left ventricular (LV) short-axis images were recorded.
Main Results:
- All patients in Group 1 showed normal wall motion throughout the test.
- All patients in Group 2 exhibited new wall motion abnormalities during walking, which resolved post-exercise.
- Ambulatory echocardiography successfully identified these exercise-induced abnormalities in CAD patients.
Conclusions:
- Ambulatory echocardiography is effective in detecting transient wall motion abnormalities in patients with CAD.
- The technique shows potential for evaluating myocardial ischemia in specific patient populations.
- This portable method may aid in the diagnosis and management of CAD.
Background:
This investigation was designed to determine whether transient wall motion abnormalities due to myocardial ischemia induced by walking could be detected by ambulatory echocardiography.
Methods:
Two groups were studied. Group 1 consisted of 10 males (mean age 34 years) who had no symptoms of angina. Group 2 consisted of eight selected patients (mean 61 years) with angina and angiographic evidence of coronary artery disease. The 2.5 MHz transducer is spherical in its distal part and mounted in an external housing to permit steering in 360°. The external housing was attached to the chest wall using an adhesive patch. The transducer was placed in the 3rd or 4th intercostal space at the left sternal border to permit imaging of the left ventricle (LV) in its short axis and attached to the chest wall. The transducer was interfaced with an Acuson Cypress echocardiography system which was placed on a mobile cart. To permit portability, the echocardiography system was powered by a capacitor (UPS device). The subjects were asked to walk along the corridor as fast as possible for 10 minutes or until the onset of symptoms while pushing the cart. The short axis of the LV was displayed on a monitor and recorded on optical disks.
Results:
The heart rate, systolic blood pressure (SBP), and double product of Group 1 at rest were 77 ± 3 beats/min, 119 ± 13 mmHg, and 9,150 ± 868, respectively, and increased to 106 ± 8 beats/min, 129 ± 15 mmHg, and 1,3793 ± 2,176 with walking. The baseline heart rate, SBP, and double product were 71 ± 12 beats/min, 130 ± 14 mmHg, and 8,555 ± 1,928 in Group 2 and increased to 94 ± 14 beats/min, 135 ± 20 mmHg, and 12,480 ± 3,830 with walking. All patients in Group 1 had normal wall motion at rest and during walking. Patients in Group 2 had normal wall motion during rest and new wall motion abnormalities were noted in all subjects during walking (anterior septum and/or anterolateral wall in seven, posterolateral wall in one). The wall motion abnormalities resolved shortly after discontinuation of walking.
Conclusion:
Ambulatory echocardiography permitted the detection of transient wall motion abnormalities in patients with coronary artery disease (CAD). This technique could be potentially useful in evaluating selected patients for myocardial ischemia.
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