title: Myocardial velocity gradient as a new indicator of regional left ventricular contraction: detection by a two-dimensional tissue Doppler imaging technique.
abstract: OBJECTIVE
  This study was performed to assess a new indicator of regional left ventricular contraction determined by a two-dimensional tissue Doppler imaging technique.
  
  
  BACKGROUND
  Recent studies have demonstrated that instantaneous tissue motion velocity can be noninvasively assessed by tissue Doppler imaging. However, quantitative assessment of regional left ventricular contraction is still difficult because of the effects of the Doppler angle of incidence and parallel motion of the whole heart.
  
  
  METHODS
  We assessed left ventricular wall motion in 11 normal subjects, 14 patients with an old myocardial infarction (anteroseptal in 7, posterior in 7) and 8 patients with dilated cardiomyopathy. Tissue Doppler velocity was corrected by the Doppler angle of incidence after the hypothetical center of contraction was set. Subsequently, the myocardial velocity gradient between the endocardium and epicardium was determined from the velocity profile along each radial line from the center of contraction by using least squares linear regression.
  
  
  RESULTS
  In normal subjects, peak myocardial velocity gradient was lower in the anteroseptal wall (mean [+/- SD] 1.69 +/- 0.53 s-1) than in the posterior wall (3.28 +/- 0.67 s-1, p < 0.01). Myocardial velocity gradient in the infarct regions was significantly lower (anteroseptal 0.58 +/- 0.41 s-1, p < 0.05; posterior 0.17 +/- 0.27 s-1, p < 0.01) than that in normal subjects as well as that in the corresponding noninfarct regions (2.84 +/- 0.37 s-1 and 1.48 +/- 0.25 s-1, p < 0.01, respectively). In patients with dilated cardiomyopathy, myocardial velocity gradient was generally lower (anteroseptal 0.72 +/- 0.59 s-1; posterior 0.93 +/- 0.67 s-1) than that in normal subjects (p < 0.01).
  
  
  CONCLUSIONS
  These results demonstrate that regional left ventricular contraction can be quantitatively assessed by the myocardial velocity gradient derived from two-dimensional tissue Doppler imaging. We suggest that myocardial velocity gradient has potential for the quantitative assessment of regional left ventricular contraction abnormalities in patients.
authors.affiliation: Department of Cardiovascular Dynamics, National Cardiovascular Center Research Institute, Osaka, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Uematsu
authors.forename: K
authors.initials: K
authors.lastname: Miyatake
authors.forename: N
authors.initials: N
authors.lastname: Tanaka
authors.forename: H
authors.initials: H
authors.lastname: Matsuda
authors.forename: A
authors.initials: A
authors.lastname: Sano
authors.forename: N
authors.initials: N
authors.lastname: Yamazaki
authors.forename: M
authors.initials: M
authors.lastname: Hirama
authors.forename: M
authors.initials: M
authors.lastname: Yamagishi
mesh_terms: D000328:Adult; D000368:Aged; D002311:Cardiomyopathy, Dilated / Q000000981:diagnostic imaging / Q000503:physiopathology*; D015150:Echocardiography, Doppler; D005069:Evaluation Studies as Topic; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D016018:Least-Squares Analysis; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology*; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000503:physiopathology*; D016276:Ventricular Function