title: [Pulse-wave Doppler Tissue Imaging in the assessment of regional left ventricular diastolic function in patients with coronary artery disease].
abstract: OBJECTIVE
  Myocardial ischemia impairs the diastolic left ventricular (LV) function earlier than the systolic function. We evaluated the value of pulse-wave Doppler Tissue Imaging (DTI) in the study of regional myocardial function of LV in patients with coronary artery disease.
  
  
  METHODS
  We performed a prospective study in 60 patients with coronary artery disease that we compared to 40 healthy individuals in order to assess the value of pulse-wave DTI to study the diastolic LV function . Both groups had a clinical examination, ECG, echocardiography and pulse-wave DTI. Only the patients had a coronary angiography. Pulse-wave DTI was applied to the 16 myocardial segments of the LV, we measured the isovolumetric relaxation time (IVRT), early (Ea) and late diastolic (Aa) velocities.
  
  
  RESULTS
  We have demonstrated that compared with healthy subjects, patients with coronary artery disease has a significant increase of IVRT (100.2 +/- 20 ms vs 62.5 +/- 12.2, p <0.001) and lower Ea (7.6 +/- 1.6 vs. 9.2 +/- 2.6) and report Ea / Aa. These anomalies are more pronounced in akinetic segments compared with hypokinetic segments. Relying on data from the coronary angiography, we found in patients that IVRT had increased, Ea and Ea / Aa lowered in most segments hypoperfused than in normally perfused segments. An IVRT > 70ms and Ea <8.3 cm / s emerge as threshold values to identify myocardial ischemia. More coronary lesions are severe more Ea and Ea/Aa decline and IVRT increase. The culprit coronary artery could be identified by pulse- wave DTI since the DTI parameter anomalies are systemized
  
  
  CONCLUSIONS
  The pulsed DTI technique seems to be attractive as a non-invasive evaluation method of ischemic heart disease.
authors.affiliation: Service de Cardiologie, Hôpital Habib Thameur, Tunis.
authors.forename: Sana
authors.initials: S
authors.lastname: Fennira
authors.forename: Fathia
authors.initials: F
authors.lastname: Ben Moussa
authors.forename: Yassine
authors.initials: Y
authors.lastname: Ellouze
authors.forename: Sondos
authors.initials: S
authors.lastname: Kraiem
authors.forename: Med Lotfi
authors.initials: ML
authors.lastname: Slimane
mesh_terms: D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D003971:Diastole; D018619:Echocardiography, Doppler, Pulsed; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016277:Ventricular Function, Left