title: Reversal of intraventricular flow propagation during isovolumic relaxation: A marker of anterior wall dysfunction.
abstract: 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.
authors.affiliation: Medical Department B, Section of Cardiology, The National Hospital, University of Oslo, Norway. thor.edvardsen@rh.uio.no
authors.forename: T
authors.initials: T
authors.lastname: Edvardsen
authors.forename: O
authors.initials: O
authors.lastname: Rodevand
authors.forename: S
authors.initials: S
authors.lastname: Aakhus
authors.forename: R
authors.initials: R
authors.lastname: Bjornerheim
authors.forename: H
authors.initials: H
authors.lastname: Ihlen
mesh_terms: 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*