Tissue doppler imaging predicts recovery of left ventricular function after recanalization of an occluded coronary artery.
OBJECTIVE
We tested the hypothesis that the tissue Doppler imaging (TDI)-derived positive preejection velocity (+VIC) can predict the recovery of contractile function after revascularization in patients with a recent myocardial infarction.


BACKGROUND
In experimental studies, the presence and extent of TDI-derived +VIC correlated with the extent of viable myocardium.


METHODS
Forty-three patients with a large myocardial infarction and an occluded left anterior descending (n = 38) or dominant right coronary (n = 5) artery were selected. The median duration of occlusion was 24 h. Longitudinal myocardial velocities were recorded at rest by pulsed-wave TDI echocardiography 6 +/- 2 h after revascularization. Functional recovery was defined as an increase in segmental chordal shortening > or =10% at three-month follow-up left ventricular angiogram as compared with baseline.


RESULTS
A good quality TDI signal was obtained in 309 of 324 analyzed segments (95.4%). Severe dysfunction was present in 198 segments of which 126 (64%) showed recovery at three-month follow-up. Sampling of all dysfunctional segments lasted 11 +/- 4 min per patient. Sensitivity, specificity, and accuracy of the +VIC to predict segmental recovery were 91%, 71%, and 84%, respectively. The percentage of segments that were dysfunctional at angiography but showed a +VIC correlated with improvement of both global left ventricular ejection fraction (r = 0.60, p = 0.001) and wall motion score index (r = -0.78, p < 0.0001) at follow-up.


CONCLUSIONS
Assessment of +VIC by pulsed-wave TDI is a simple and accurate method that predicts recovery of contractile function after revascularization in patients with a recent myocardial infarction.
Penicka
Martin
M
Cardiovascular Center, Aalst, Belgium.
Bartunek
Jozef
J
Wijns
William
W
De Wolf
Ilse
I
Heyndrickx
Guy R
GR
De Raedt
Herbert
H
Barbato
Emanuele
E
De Bruyne
Bernard
B
D015906:Angioplasty, Balloon, Coronary; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D020127:Recovery of Function; D015203:Reproducibility of Results; D014463:Ultrasonography; D016277:Ventricular Function, Left