Use of color kinesis for evaluation of left ventricular filling in patients with dilated cardiomyopathy and mitral regurgitation.
OBJECTIVE
We tested the feasibility of using analysis of color kinesis images to objectively assess global and regional left ventricular (LV) diastolic function in patients with dilated cardiomyopathy (DCM). In addition, the ability of this technique to track drug-induced changes on LV diastolic properties was studied.


BACKGROUND
Diastolic dysfunction contributes to symptomatology in patients with DCM. The assessment of LV diastolic function using conventional Doppler echocardiography is indirect and is confounded by multiple variables. Moreover, the noninvasive evaluation of regional diastolic properties is difficult. In contrast, color kinesis directly tracks and color-encodes regional diastolic endocardial motion.


METHODS
We studied 24 patients with DCM and mitral regurgitation (MR) and 24 age-matched normal subjects. Transmitral and pulmonary vein flow velocities were measured using pulsed Doppler echocardiography. Diastolic color kinesis images were used to calculate indexes of magnitude and timing of global and regional diastolic function. Diastolic asynchrony was evaluated in different subgroups of patients with DCM. The effects of drug infusions (nitroprusside and dobutamine) were also studied.


RESULTS
Color kinesis indexes of global diastolic function showed significant differences between patients with DCM and normal subjects. Compared with Doppler indexes, color kinesis was less confounded by MR and was capable of differentiating between drug-induced lusitropic and vasodilator effects. Diastolic asynchrony was increased in patients with DCM and severe MR.


CONCLUSIONS
Quantitative analysis of global and regional LV diastolic function in patients with DCM using color kinesis is feasible.
Godoy
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IE
Department of Medicine, University of Chicago, Illinois, USA. igodoy@medicine.bsd.uchicago.edu
Mor-Avi
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V
Weinert
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Vignon
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P
Korcarz
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Spencer
K T
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Lang
R M
RM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002311:Cardiomyopathy, Dilated / Q000503:physiopathology*; D002316:Cardiotonic Agents / Q000494:pharmacology; D003971:Diastole / Q000187:drug effects / Q000502:physiology*; D004280:Dobutamine / Q000494:pharmacology; D004452:Echocardiography / Q000379:methods*; D015150:Echocardiography, Doppler; D004699:Endocardium / Q000000981:diagnostic imaging; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000503:physiopathology*; D009599:Nitroprusside / Q000494:pharmacology; D014665:Vasodilator Agents / Q000494:pharmacology; D016277:Ventricular Function, Left / Q000187:drug effects
D002316:Cardiotonic Agents; D014665:Vasodilator Agents; D009599:Nitroprusside; D004280:Dobutamine