Reversal of intraventricular flow propagation during isovolumic relaxation: A marker of anterior wall dysfunction.
BACKGROUND
Myocardial infarction induces left ventricular (LV) wall motion abnormalities during isovolumic relaxation (IVR) and may potentially alter intraventricular flow during this period. This study evaluated whether 2-dimensional color Doppler measurements of intraventricular flow during IVR were able to identify LV dysfunction caused by coronary artery disease.


METHODS
Patients with single-vessel coronary artery disease and posterior wall infarction (21 patients) or anterior wall infarction (27 patients) were included. Eighteen healthy persons served as a control group. LV function was examined by 2-dimensional echocardiography, 2-dimensional color Doppler, and pulsed Doppler techniques.


RESULTS
All normal persons (23.6 +/- 10.9 cm/s) and patients with posterior infarction (19.6 +/- 9.3 cm/s) had flow propagation towards LV apex during IVR. Patients with anterior wall infarction had reversed flow direction (-12.2 +/- 8.7 cm/s, P <.001). The echocardiographic wall motion score index of the 4 apical segments correlated well with flow velocities (r = -0.78, P <.001).


CONCLUSIONS
Reversed flow propagation during IVR may become a sensitive clinical marker of regional ischemia.
Edvardsen
T
T
Medical Department B, Section of Cardiology, The National Hospital, University of Oslo, Norway. thor.edvardsen@rh.uio.no
Rodevand
O
O
Aakhus
S
S
Bjornerheim
R
R
Ihlen
H
H
D000704:Analysis of Variance; D001783:Blood Flow Velocity; D016022:Case-Control Studies; D017023:Coronary Angiography; D003326:Coronary Circulation; D003327:Coronary Disease / Q000503:physiopathology; D003971:Diastole / Q000502:physiology; D018618:Echocardiography, Doppler, Color; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D009203:Myocardial Infarction / Q000503:physiopathology*; D015203:Reproducibility of Results; D013599:Systole / Q000502:physiology; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000503:physiopathology*