title: Influence of left ventricular size and hemodynamics on the systolic longitudinal myocardial Doppler velocity response to stress.
abstract: BACKGROUND
  Systolic myocardial Doppler velocity accurately identifies coronary artery disease. However, these velocities may be affected by age, hemodynamic responses to stress, and left ventricular cavity size. We sought to examine the influences of these variables on myocardial velocity during dobutamine stress in patients with normal wall motion.
  
  
  METHODS
  One hundred seventy-nine consecutive patients with normal dobutamine echocardiograms were studied. Color myocardial tissue Doppler data were obtained at rest and peak stress, and peak systolic myocardial velocity (PSV) was measured in all basal and midventricular segments. Velocities at rest and peak stress were compared with left ventricular diastolic and systolic volumes, blood pressure, heart rate, and age by Pearson correlation and interdecile analysis by use of analysis of variance.
  
  
  RESULTS
  The only clinical variable correlating with velocity was age; PSV showed only mild correlation with age at rest (r2 = 0.01, P =.001) and peak stress (r2 = 0.02, P =.001), but the normal peak velocity was significantly different between the extremes of age (<44 years and >74 years). There was very weak correlation of PSV with systolic and diastolic blood pressure (r2 < 0.01), heart rate (r2 < 0.01), systemic vascular resistance (r2 = 0.08), and left ventricular volumes (r2 < 0.01).
  
  
  CONCLUSIONS
  Peak systolic velocity during dobutamine stress is relatively independent of hemodynamic factors and left ventricular cavity size. The extremes of age may influence peak systolic Doppler velocities. These results suggest that peak systolic velocity may be a robust quantitative measure during dobutamine echocardiography across most patient subgroups.
authors.affiliation: University of Queensland, Brisbane, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: Cain
authors.forename: Sheree
authors.initials: S
authors.lastname: Napier
authors.forename: Brian
authors.initials: B
authors.lastname: Haluska
authors.forename: Leanne
authors.initials: L
authors.lastname: Short
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Marwick
mesh_terms: D000704:Analysis of Variance; D001794:Blood Pressure / Q000502:physiology; D002316:Cardiotonic Agents; D004280:Dobutamine; D025401:Echocardiography, Stress; D006339:Heart Rate / Q000502:physiology; D006352:Heart Ventricles / Q000033:anatomy & histology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology*; D013599:Systole; D016277:Ventricular Function, Left / Q000502:physiology*
chemical_list: D002316:Cardiotonic Agents; D004280:Dobutamine