Copyright © 2006, The European Society of Cardiology
Potential use of isovolumic contraction velocity in assessment of left ventricular contractility in man: A simultaneous pulsed Doppler tissue imaging and cardiac catheterization study
aDepartment of Cardiology, Heart Centre, University Hospital, Umeå, Sweden
bDepartment of Cardiology, Uppsala University Hospital, Uppsala, Sweden
cDepartment of Internal Medicine, Faculty of Medicine and Health Sciences, United Arab Emirates University, P.O. Box 17666, Al-Ain, United Arab Emirates
Received 23 November 2005; received in revised form 6 April 2006; accepted after revision 23 April 2006.
kazzam{at}uaeu.ac.ae
* Corresponding author. Tel.: +971 3 713 7654; fax: +971 3 767 2995.
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Abstract |
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Aims Echocardiographic techniques have so far provided suboptimal estimates of myocardial contractility in humans. Longitudinal myocardial motion during the isovolumic contraction (IVC) phase, measured by colour tissue Doppler imaging (TDI), has recently been shown in experimental animal models to reflect the state of myocardial contractility. The aim of the present study was to investigate the relationship between left ventricular (LV) isovolumic contraction velocities (IVCv) using pulsed Doppler tissue imaging (DTI) and global LV contractility as measured during cardiac catheterization.
Methods and results Cardiac catheterization and pulsed DTI were simultaneously performed in 16 consecutive patients (13 males, mean age 55±10years) with a variety of cardiac diseases. Relationships between the peak positive IVCv as measured at basal levels of the lateral, septal, anterior and posterior walls and the first derivative of LV pressure (+dP/dtmax), were investigated.
Peak IVCv measurements were obtainable in 81–100% of the four LV wall segments. Statistically significant linear relationships were found between IVCv and +dP/dtmax at the lateral (r=0.58, P<0.05), septal (r=0.66, P<0.01), anterior (r=0.73, P<0.01) and posterior (r=0.81, P<0.001) segments of the LV.
Conclusion IVCv of the basal four LV walls correlates strongly with peak +dP/dt. IVCv is a readily obtainable non-invasive parameter, which correlates with the classical invasive measurement of global LV contractility. It appears likely that there are regional differences in wall motion when DTI is used to determine state of LV contractility.
Keywords: Cardiac catheterization; Doppler tissue imaging; Isovolumic contraction velocity; Left ventricular contractility
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