Longitudinal Myocardial Displacement and Strain Rate in the Hypertrophied Heart Evaluated by Tissue Strain imaging With Doppler Angle Correction and Tissue Tracking Technique

S Noninvasive Imaging 455A JACC March 19,2003 and MVP was analyzed off-line. Results : 1) Wall motion score index (WMSI) assessed by PDE decreased significantly in 9 of 12 patients (75%) reflecting improvement of regional wall motion abnormality. 2) In contrast, in 11 of 12 patients (92%) the peak systolic myocardial velocity (1.17 vs 4.97cm!s, p < 0.001) and transmyocardial velocity gradient (0.06 vs 3.26 s-‘, p < 0.061) obtained by MVP at the region suspected to be viable increased significanty. Conclusions: hlyocardial velocity profile (MVP) obtained from color TDI during low dose DSE quantitatively assessed myccardial viability in patients with myocardial infarction. MVP was better sensitive than evaluation using conventional WMSI. 1199-37 Tissue Doppler Imaging Pattern of Left Bundle Branch Block Is a Strong Predictor for Mortality in Patients With Heart Failure Rachek Adorisio, Cristina M. Volponr, Massimo Mancone, Chiara Bucciarelli, Leonardo De Luca, Salvatore Musarb, Francesco Fed&e, Universita La Sapienza Dip Scienza Cardiovascolari e Respiratorie, Roma, Italy Background Recent studies had established that left bundle branch block (LBBB) is a strong predictor for mortakty in patients wrth heart failure (HF). Aim of the study was to assess if different electromechanical pattern due to LBBB, established by Tissue Doppler Imaging. had an rnfluence on mortality rn patients with HF. Methods We studied 21 patients with LBBB and dilated cardiomyopathy with 2D echocardiography and Tissue Doppler Imaging (TDI). We analyzed qualitatively color coded M-mode of interventricular septum (IVS) and the following electromechanical patterns were identified: mildly unsyncronized (//A), severely unsyncronized (//B), reversed early in systole (///A) reversed late in systole (l/i@. reversed throughtout all the systole (IV). All patients were divided in three groups, according to left ventricular function (LVEF): Group I: ~30% LVEF; Group If: 30.40% ; Group /I/: >40%. We considered also age, NYHA functional class, QRS narrowing and mitral regurgitation for multivariate analysis. Results The highest mortality rate (100%) was observed in IIIB electrical-mechanical pattern and LVEF 30-40%, while the lowest mortality rate (25%) was related to IIA TDI pattern with LVEF ~30% (100% vs 25%, p< 0.01). The multivariate analysis show that the electromechanical pattern is a strong predictor for mortality indipendently from age. NYHA functional class, QRS narrowing, mitral regurgitation (x2= 0; df=l). Conclusions TDI is an useful method to assess the severity of LV asincrony. The electromechanical pattern is a strong predictor on mortality, rndipendently from LVEF, rn HF patients. 1189-38 Longitudinal Myocardial Displacement and Strain Rate in the Hypertrophied Heart Evaluated by Tissue Strain imaging With Doppler Angle Correction and Tissue Tracking Technique Tomotsuau Tabata, Hideji Tanaka, Eriko Kimura, Kenji Harada, Tetsuzo Wakatsuki, Takashi Yamamoto, Akihiro Saito, Kozo Uehara, Norihito Kageyama. Hirotsugu Yamada, Takashi Oki. The University of Tokushima, Tokushima, Japan, The National HigashiTokushima Hospital, Tokushima, Japan Background: The left ventricular (LV) systolic function in the long-axis direction has been evaluated by pulsed tissue Doppler mitral annular motion velocity. However, it could not avoId the effect of cardiac translation. A prototype software (ApliQ, Toshiba Corp.) was recently developed to obtain tissue strain imaging (TSI). In this program. the center of contraction was set in the LV cavity and velocity was automatically angle-corrected. The velocity values from the same region of moving myocardium were automatically defined and interrogated over time to yield displacement by 2D tissue Doppler tracking technique. TSI was finally obtained as a spatial derivative of the tissue displacement. Purpose To evaluate longrtudinal LV myocardial contractile characteristics in hypertrophied heart using TSI. Methods Subjects consisted of 20 normal (N), 20 hypertensive hypertrophy (HHD) and 12 asymmetric septal hypertrophy (ASH). Color tissue Doppler image was recorded from apical four chamber view and the TSI at the base of ventricular septum was analyzed off-line. Results Peak systolic displacement (Dp) and peak systolic strain rate (SRp) decreased and time to Dp prolonged in hypertrophied heart (table). Conclusions: Longitudinal myocardial fiber contraction was depressed in hypertrophied ventricular septum especially in asymmetric hypertrophy. TSI with Doppler angle correction and tissue trackrng can quantitatively evaluate longitudinal LV contractility regardless of cardiac translation.