Myocardial Doppler tissue imaging: findings in inferior myocardial infarction and left ventricular hypertrophy--wall motion assessment.
BACKGROUND
Because of the geometry of the basal inferior wall and its relation with the posterior medial papillary muscle, differentiating abnormal from normal basal inferior wall motion can be challenging.


METHODS
We performed pulsed wave Doppler echocardiography of the basal inferior wall and basal interventricular septum in 26 patients (63 +/- 14 years) with a normal echocardiogram, 33 patients (67 +/- 14 years) with inferior myocardial infarction (MI) associated with hypokinesis to dyskinesis of the basal inferior wall, and 38 patients (67 +/- 14 years) with left ventricular hypertrophy (LVH).


RESULTS
Systolic velocity was significantly lower in the basal interventricular septum (0.071 +/- 0.013 m/s versus 0.084 +/- 0.023 m/s) and basal inferior wall (0.075 +/- 0.014 m/s versus 0.085 +/- 0.019 m/s) in the MI group compared with the LVH group, and both were significantly lower compared with normal values at the interventricular septum (0.090 +/- 0.023 m/s, P <.001, analysis of variance) and basal inferior wall (0.095 +/- 0.014 m/s, P <.0001, analysis of variance). The sum of the systolic (S), early diastolic (E'), and late diastolic (A') velocities of 0.30 m/s at the basal inferior wall had 91%, 76%, and 84% sensitivity, specificity, and accuracy, respectively, for the differentiation of a normal wall from an infarcted basal inferior wall, and 76%, 73%, and 75% sensitivity, specificity, and accuracy, respectively, for the differentiation of a normal wall from a hypertrophied basal inferior wall. The sum of systolic and diastolic velocities of 0.25 m/s at the basal interventricular septum had 70%, 66%, and 68% sensitivity, specificity, and accuracy, respectively, for the differentiation of an infarcted from a hypertrophied basal interventricular septum. Mitral inflow early-filling wave deceleration time by pulsed wave Doppler was the most sensitive parameter for the differentiation of LVH from MI (P <.0001).


CONCLUSIONS
Doppler tissue imaging velocities of the basal inferior wall and basal interventricular septum may help differentiate normal from infarcted and hypertrophied myocardium.
Naqvi
T Z
TZ
Cardiac Non-Invasive Laboratory, Division of Cardiology, Department of Medicine, Cedars-Sinai Medical Center, UCLA School of Medicine, Los Angeles, California 90048, USA. tasneem.naqvi@cshs.org
Neyman
G
G
Broyde
A
A
Siegel
R J
RJ
D000368:Aged; D000369:Aged, 80 and over; D018619:Echocardiography, Doppler, Pulsed / Q000379:methods*; D005260:Female; D006346:Heart Septum / Q000000981:diagnostic imaging; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009038:Motion; D009200:Myocardial Contraction; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000503:physiopathology; D012680:Sensitivity and Specificity