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
Gardien M, Simoons ML, Frossard P. Heart attack and angina
stastistics. Am Heart J 2006;15:110–39.
Malik IA, Mahmood K, Raja K. Acute myocardial infarction.
Professional Med J 2005;12:457–65.
Thune JJ, Solnion SD. Left Ventricular Diastolic Function
following Myocardial Infarction. Current Heart Failure Reports
McMurrey JJ. Clinical practice. Systolic Heart Failure. N Eng
J Med 2010;362(3):228–38.
Mottram PM, Marwick TH. Assessment of diastolic dysfunction:
what the General Cardiologist needs to know. Heart
Gotsman I, Zwas D, Planer D, Livshits TA, Admon D, Lotan C et
al. Clinical Outcome of Patients with Heart Failure and Preserved
Left Ventricular Functions. Am J Med 2008;121:999–1001.
Nagueh SF. Tissue Doppler Imaging Imaging for the Assessment
of Left Ventricular Diastolic Function. J Cardiovasc Ultrasound
Nagueh SF. Echocardiographic evaluation of left ventricular
diastolic function. Curr Cardiovasc Imag Rep 2008;1(1):30–8.
Gabriel RS, Klein LA. Modern evaluation of left ventricular
diastolic function using Doppler Echocardiography. Curr Cardiol
Palmary V, Innocenti F, Pini R, Celentano A. Reproducibility of
Doppler echocardiographic assessment of left ventricular
diastolic function in multicenter setting. J Am Soc Echocardiogr
Sherif F, Nagueh, Christopher P, Appleton C, Thierry, Gillebert
et al. Recommendation for the evaluation of left ventricular
diastolic function by Echocardiography. Eur J Echocardiogr
Zaca V, Ballo P, Galderisi M, Mondillo S. Echocardiography in
Assessment of left ventrical longitudinal systolic function:
Current Methodology and Clinical Applications. Heart Fail Rev
Ali L, Abid AR, Mohyuddin MT, Azhar M. Echocardiographic
evaluation of patients with diastolic dysfunction. Pak J Cardiol
Ahmed A, Wilbert S, Jerome L. New York Heart Association
classes and increased mortality and hospitalization in patients
with heart failure and preserved left ventricular function. Am
Heart J 2006;151:444–50.
Mollema SA, Nuafora G, Bax JJ. Prognostic value of
Echocardiography after acute Myocardial Infarction. Heart
Ren X, Ristow B, Na B, Ali S, Schiller NB, Whooley MA.
Prevalence and Prognosis of Asymptomatic Left Ventricular
Diastolic Dysfunction in Ambulatory Patients With Coronary
Heart Disease. Am J Cardiol 2007;99:1643–7.
Salehi R, Alizadehasl A, Rostamzadeh M, Sepasi F, Abbasnejad
M. Evaluation of Systolic And Diastolic Function of Left
Ventrical by using velocities of Mitral Annulus in patients with
first acute Anterior Myocardial Infarction and their one month
follow-up. J Cardiovasc Thorac Res 2010;2(1):9–15.
Sidddique T, Javed F, Quaeshi IH, Riaz MK. Assessment of
diastolic dysfunction in hypertensive patients and its association
with left ventricular mass index. Ann King Edward Med Coll
Wang M, Yip G, Yu CM, Zhang Q, Zhang Y, Tse D, et al.
Independent and incremental prognostic value of early mitral
annulus velocity in patients with impaired left ventricular systolic
function. J Am Coll Cardiol 2005;45:272–7.
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