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Myocardial Imaging (myocardial + imaging)

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Medical Sciences	100%

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Clinical and Echocardiographic Aspects of Mid-Ventricular Hypertrophic Cardiomyopathy

ECHOCARDIOGRAPHY, Issue 6 2005
Francisco Martínez Baca-López M.D.
Three cases of patients with hypertropic cardiomyopathy, apical aneurysm, and mid-ventricular obstruction are presented. Two patients were diagnosed first by two-dimensional and Doppler echocardiography, which showed mid-ventricular obliteration, characteristic hourglass image, and paradoxic jet flow. One patient with suboptimal echocardiogram was necessary to perform contrast echocardiogram. Clinical picture was characterized by angina and dyspnea. Thallium myocardial imaging revealed perfusion abnormalities in apical region, ischemia or necrosis. Cardiac catheterism showed mid-ventricular obliteration and significant intraventricular gradient and coronary arteries angiography without lesions. [source]

Estimation of Global Left Ventricular Function from the Velocity of Longitudinal Shortening

ECHOCARDIOGRAPHY, Issue 3 2002
Dragos Vinereanu M.D., E.C., Ph.D.
Aims: To determine if global ventricular function can be assessed from the long-axis contraction of the left ventricle, we compared pulsed-wave Doppler myocardial imaging of mitral annular motion to radionuclide ventriculography. Methods and Results: We studied 51 patients (56 ± 10 years, 11 women) with a radionuclide ejection fraction of 52 ± 13% (15%,70%). Peak systolic velocities of medial and lateral mitral annular motion correlated with ejection fraction (0.55 and 0.54, respectively; P < 0.001), as did the time-velocity integrals (0.57 and 0.58, respectively; P < 0.001). Correlations were higher in normal ventricles (0.62,0.69) than in patients with previous myocardial infarction (0.39,0.64). Patients with anterior myocardial infarction had the lowest correlations (0.39,0.46). The best differentiation of normal (, 50%) from abnormal (< 50%) ejection fraction was provided by peak systolic velocity , 8 cm/sec for the medial (sensitivity 80%, specificity 89%) or lateral (sensitivity 80%, specificity 92%) mitral annulus. Conclusion: Global left ventricular function can be estimated by recording mitral annular velocity. The implementation of a cutoff limit of 8 cm/sec gave a simple guide for differentiating between normal and abnormal left ventricular systolic function that might be useful clinically in patients without regional wall-motion abnormalities. However, in patients with important segmental wall-motion abnormalities during systole, left ventricular longitudinal shortening is an imperfect surrogate for ejection fraction. [source]

Postsystolic thickening detected by doppler myocardial imaging: A marker of viability or ischemia in patients with myocardial infarction

CLINICAL CARDIOLOGY, Issue 1 2004
Jae-Kwan Song M.D.
Abstract Background: Postsystolic thickening (PST) of ischemic myocardial segments has been reported to account for the characteristic heterogeneity or regional asynchrony of myocardial wall motion during acute ischemia. Hypothesis: Postsystolic thickening detected by Doppler myocardial imaging (DMI) could be a useful clinical index of myocardial viability or peri-infarction viability in patients with myocardial infarction (MI). Methods: Doppler myocardial imaging was recorded at each stage of a standard dobutamine stress echocardiogram (DSE) in 20 patients (16 male, 60 ± 13 years) with an MI in the territory of the left anterior descending artery. Myocardial velocity data were measured in the interventricular septum and apical inferior segment of the MI territory. Postsystolic thickening was identified if the absolute velocity of PST was higher than peak systolic velocity in the presence of either a resting PST > 2.0 cm/s or if PST doubled at low-dose dobutamine infusion. Results: Doppler myocardial imaging data could be analyzed in 38 ischemic segments (95%), and PST was observed in 21 segments (55%), including 3 segments showing PST only at low-dose dobutamine infusion. There was no significant difference of baseline wall motion score index (2.1 ± 0.3 vs. 2.1 ± 0.6, p = 0.77) orpeak systolic velocity (1.1 ± 1.1 vs. 1.9 ± 2.0 cm/s, p = 0.05) between segments with and without PST. Peri-infarction ischemia or viability during DSE was more frequently observed in segments with PST than in those without (86 vs. 24%, p < 0.05). The sensitivity and specificity of P ST for prediction of peri-infarction viability or ischemia was 82 and 81%, respectively. Conclusions: Postsystolic thickening in the infarct territory detected by DMI is closely related with peri-infarction ischemia or viability at DSE. [source]