[Myocardial Doppler tissue imaging: past, present and future].
The first Doppler spectral and pulsed tissue recordings in 1992 have given way to a new generation of machines which enable cardiologists to study mechanical events of the myocardium during the cardiac cycle by Doppler tissue imaging. This technique provides valuable information about regional function with quantitative analysis of the velocities within the myocardial wall as opposed to the global qualitative or semi-quantitative character of usual echocardiographic data. The velocity mode is the most commonly used in its three different presentations: two-dimensional, M mode and, more traditionally, pulsed spectral modes. Two-dimensional imaging gives a global view of the different myocardial segments and allows a rapid approximation of the differences of velocities between these segments and of myocardial wall thickness; however, it lacks the temporal resolution of pulsed Doppler and M mode. In addition, M mode with automatic programmes of velocity analysis has the advantage of providing a continuous spatio-temporal recording of the velocities within the myocardial wall, layer by layer. There is a physiological gradient of velocities highest at the endocardium and lowest at the epicardium. Despite the present limitations related to the Doppler principle itself, the technology, and the complexity of myocardial architecture, Doppler tissue imaging is a useful complement to information already available concerning pressures, flow and cardiac structures. The future is promising and should exceed this simple complementarity to existing ultrasound methods. Progress in the fields of ultrasound physics, technology, computerisation for acquisition of two- and three-dimensional imaging should provide a new physiopathological approach to the understanding of wall motion changes during cardiac disease.
Veyrat
C
C
CNRS/INSERM U 141, hôpital Lariboisière, Paris.
Pellerin
D
D
Larrazet
F
F
D000818:Animals; D001783:Blood Flow Velocity; D009202:Cardiomyopathies / Q000000981:diagnostic imaging*; D018619:Echocardiography, Doppler, Pulsed / Q000295:instrumentation / Q000379:methods; D006321:Heart / Q000503:physiopathology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D009200:Myocardial Contraction; D012680:Sensitivity and Specificity; D016276:Ventricular Function
Imagerie Doppler tissulaire du myocarde. Passé, présent et avenir.