Quantification of regional left ventricular systolic dysfunction in patients with coronary artery disease by pulsed Doppler tissue imaging.

OBJECTIVES To analyze and compare quantitatively regional myocardial functional abnormalities of the left ventricle by pulsed Doppler tissue imaging (DTI) in patients with unstable angina (UA) and prior myocardial infarction (MI), and to explore the value of systolic velocity and time intervals in evaluating regional left ventricular systolic dysfunction. METHODS Patients with coronary artery disease (CAD) were divided into UA (16 cases) and anterior wall MI (ant-MI, 21 cases) groups. Sixteen age-matched normal subjects served as the control group. The septal and lateral, anterior and inferior walls of the left ventricle were displayed, and basal and middle segments of each wall were selected for myocardial motion spectrum sampling. DTI parameters were: peak systolic myocardial velocity (s), regional pre-ejection period (PEP), time to peak of the systolic wave (Ts), regional ejection time (ET) and PEP/ET ratio. RESULTS Compared with the control group, s was significantly lower in all segments in the ant-MI group, and in lateral and anterior segments in the UA group. It was even lower in the ant-MI than in the UA group, and in infarct compared with corresponding non-infarct segments in the ant-MI group. PEP and Ts were significantly longer in both the UA and the ant-MI groups. CONCLUSION Not only s, but also PEP and Ts as measured by pulsed DTI are sensitive markers of regional left ventricular systolic dysfunction in patients with CAD; s and PEP may even indicate the severity of myocardial ischemia and aid in estimating the site of MI.