Tissue Doppler and innovative myocardial-deformation imaging techniques for assessment of myocardial viability.
OBJECTIVE
Visual analysis of stress echocardiography allows evaluation of myocardial viability in acutely and chronically impaired left-ventricular function. Tissue Doppler and derived echocardiographic imaging techniques provide a tool for quantification of regional left-ventricular function which overcomes the limitations of subjective, experience-dependent reading of stress echocardiography.


RESULTS
Regional systolic and diastolic myocardial velocities as well as the derived myocardial-deformation parameters strain and strain rate are impaired in patients with left-ventricular dysfunction. Increase of myocardial velocities, strain and strain rate during stress stimulation are indicators of functional reserve in viable segments, while failure to increase indicates nonviability. Previous studies with very precise determination of regional myocardial deformation have shown that even analysis of resting function without evaluation of the functional reserve during stimulation allows assessment of myocardial viability. New two-dimensional echocardiography-based tissue-tracking techniques yield an angle-independent imaging modality that is likely to further improve the clinical applicability of echocardiographic imaging techniques to define regional myocardial viability.


CONCLUSIONS
This review attempts to define the role of tissue Doppler and new innovative myocardial-deformation imaging techniques for identification of myocardial viability in patients with impaired left-ventricular function.
Hoffmann
Rainer
R
Medical Clinic I, University Hospital RWTH Aachen, Germany. RHoffman@UKAACHEN.de
D009202:Cardiomyopathies / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D015150:Echocardiography, Doppler / Q000379:methods*; D006321:Heart / Q000503:physiopathology*; D006801:Humans; D009206:Myocardium / Q000473:pathology; D014022:Tissue Survival / Q000502:physiology*; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology