Assessment of papillary muscle function in patients with inferior wall myocardial infarction using Doppler tissue imaging.
OBJECTIVE
We sought to assess the relationship between infarct status and systolic contractile function of papillary muscle (PM) for patients with inferior wall myocardial infarction (MI).


METHODS
Peak systolic velocity (V) of posteromedial PM, systolic strain (epsilon) of posteromedial PM (epsilonPM), V of adjacent inferior wall, and of adjacent inferior wall (epsilonW) were calculated from color Doppler tissue imaging images obtained at apical views in 25 patients with inferior MI and in 13 healthy control subjects. All 25 patients with MI underwent magnetic resonance imaging to assess the infarct status of PM.


RESULTS
Compared with the control subjects, patients with MI had significantly lower V of adjacent inferior wall (5.0 +/- 0.8 vs 4.4 +/- 1.1 cm/s, P = .049) and V of posteromedial PM (4.9 +/- 0.8 vs 4.0 +/- 1.2 cm/s, P = .005), and less systolic deformation, as demonstrated by epsilonW (-17 +/- 3 vs -6 +/- 5%, P < .001) and epsilonPM (-24 +/- 5 vs -11 +/- 6%, P < .001). There was a weak positive correlation between epsilonW and epsilonPM (r = 0.393, P = .052) for patients with MI. Magnetic resonance imaging showed total infarct of PM in 14 patients (group A), with the remaining 11 revealing either normal perfusion or partial infarct of PM (group B). Although epsilonW was similar in groups A and B (-5 +/- 5% vs -8 +/- 6%, P = .20), epsilonPM was significantly lower in group B (-7 +/- 4% vs -16 +/- 4%, P = .004).


CONCLUSIONS
In patients with inferior wall MI, infarct status of the PM is variable and determines its systolic contractile function, which can be quantified by epsilon measurement using Doppler tissue imaging.
Kang
Soo-Jin
SJ
Division of Cardiology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, South Korea.
Lee
Eun Young
EY
Song
Jae-Kwan
JK
Do
Kyung-Hyun
KH
Seo
Joon Beom
JB
Lim
Tae-Hwan
TH
Song
Jong-Min
JM
Kang
Duk-Hyun
DH
Kim
Young-Hak
YH
Lee
Cheol Whan
CW
Hong
Myeong-Ki
MK
Park
Seong-Wook
SW
Park
Seung-Jung
SJ
D000328:Adult; D001783:Blood Flow Velocity / Q000502:physiology; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000503:physiopathology*; D018618:Echocardiography, Doppler, Color; D006801:Humans; D008279:Magnetic Resonance Imaging; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000503:physiopathology*; D010210:Papillary Muscles / Q000000981:diagnostic imaging / Q000503:physiopathology*; D013599:Systole / Q000502:physiology*