Diagnosis of viable myocardium using velocity data of Doppler myocardial imaging: comparison with positron emission tomography.
To test whether velocity data of Doppler myocardial imaging (DMI) at rest is useful for diagnosis of myocardial viability, 25 consecutive patients (age 64 +/- 10 years) with regional wall-motion abnormalities at the left anterior descending coronary artery territory and left ventricular dysfunction (ejection fraction: 31 +/- 7%) underwent both DMI at rest and positron emission tomography. The peak systolic velocity (Vpeak) and postsystolic thickening (PST) velocity were measured in myocardial segments of left anterior descending coronary artery territory from apical views. A total of 71 segments were classified by positron emission tomography as normal or viable in 38 (group A) and nonviable in 33 (group B). Although Vpeak did not show any difference between groups (1.81 +/- 1.77 vs 1.29 +/- 0.94 cm/s, P =.107), PST velocity was significantly higher in group A (2.48 +/- 1.68 vs 0.89 +/- 0.72 cm/s, P <.001). The sensitivity and specificity of PST velocity > 2.0 cm/s for diagnosis of viability were 61% (23/38) and 97% (32/33), respectively. In segments with PST velocity was < or =2.0 cm/s, Vpeak > 1.8 cm/s could discriminate group A from B with a sensitivity of 67% (10/15) and a specificity of 91% (29/32). The algorithm using both PST velocity and Vpeak of DMI showed sensitivity and specificity of 87% and 88%, respectively, for diagnosis of myocardial viability. Velocity data of DMI at rest provides robust information regarding viability in selected patients, and an advantage of this technique is that no stress testing is needed.
Yang
Hyun Suk
HS
Division of Cardiology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, South Korea.
Kang
Soo-Jin
SJ
Song
Jae-Kwan
JK
Moon
Dae Hyuk
DH
Song
Jong-Min
JM
Kang
Duk-Hyun
DH
Lee
Cheol Whan
CW
Hong
Myeong-Ki
MK
Kim
Jae-Joong
JJ
Park
Seong-Wook
SW
Park
Seung-Jung
SJ
D000328:Adult; D000368:Aged; D001783:Blood Flow Velocity / Q000502:physiology; D002908:Chronic Disease; D018619:Echocardiography, Doppler, Pulsed; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000503:physiopathology; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging* / Q000503:physiopathology; D009206:Myocardium / Q000473:pathology*; D049268:Positron-Emission Tomography; D012680:Sensitivity and Specificity