ASSESSMENT OF LEFT VENTRICULAR SYSTOLIC AND DIASTOLIC FUNCTION BY TISSUE DOPPLER IMAGING AFTER ACUTE MYOCARDIAL INFARCTION
AbstractObjective: To evaluate left ventricular systolic and diastolic function by Tissue Doppler imaging afteracute myocardial infarction. Methods: It was a hospital based, prospective descriptive study, from 1stJuly 2010 to 31st Dec. 2010. Total of 200 patients having acute myocardial infarction underwentdetailed tissue Doppler imaging (TDI) echocardiographic examination for evaluation of left ventricularsystolic and diastolic function on day 3, in echocardiographic section of Govt. Lady Reading Hospital,Peshawar. Peak systolic (Sm), peak early diastolic (Em) and peak late diastolic (Am) velocities wererecorded at 4 different sites of the mitral annulus. The ejection fraction and pulse wave TDI diastolicparameters were also recorded. Using SPSS version 16 data was analysed, frequencies and Mean±SDwere determined for categorical and numerical variables, respectively. A p-value ≤0.05 was consideredsignificant. Results: Total study sample was 200 patients having acute myocardial infarction (MI). Thesample was divided into 4 groups, i.e., anterior MI, inferior MI, septal MI, and lateral MI. There were122 men and 78 women and the mean age was 42±5 SD. There was a marked reduction in Sm velocityat mitral annulus, especially at the infarction sites. The mean peak systolic velocity from 4 mitralannulus sites was well correlated with ejection fraction (p=0.0001). Similar to systolic velocities, Emvelocity was also reduced, especially at the infarction sites. The mean peak early diastolic velocity from4 mitral annulus sites was well correlated with ejection fraction (p=0.0001). The mean Em velocity wascorrelated well with isovolumic relaxation time (IVRT). There was no correlation between mean Emvelocity and deceleration time (DT). Conclusion: Tissue Doppler Imaging is a reliable, accurate andeasily reproducible modality of echocardiography. The reduced peak systolic velocity and reduced peakearly diastolic velocity seems to be an expression of regionally reduced systolic and diastolic functions,respectively. While the reduced mean systolic velocity and reduced mean early diastolic velocity from4 mitral annulus sites are expressions of globally reduced systolic and diastolic functions, respectivelyand were correlated well with the ejection fraction.Keywords: Tissue Doppler imaging, ejection fraction, peak systolic velocity, peak early diastolicvelocity, deceleration time, isovolumic relaxation time
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