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CAN DOPPLER MYOCARDIAL IMAGING IDENTIFY AN IMPROVEMENT IN SEGMENTAL MYOCARDIAL FUNCTION
DIRECTLY POST PTCA? A VELOCITY,STRAIN RATE AND STRAIN STUDY
Tomasz Kukulski1, Fadi Jamal2, Bart Bijnens2, Frans Van de Verf2, Ivan de Sheerder2, George Sutherland2, George Sutherland2
1 Ślaskie Centrum Chorob Serca, Zabrze;2 University Hospital Gasthuisberg, Leuven


Background: Preliminary experimental results showed the accuracy of Colour Doppler
myocardial Imaging (CDMI) indices in the characterization of regional contractility changes
during acute myocardial ischemia.
Aim of the study: To evaluate the usefulness of this new method for monitoring segmental
myocardial function during elective PTCA in patients.
Methods: High frame rate (147 fps) CDMI data was collected in the supine position at the
end-expiratory phase for short axis views prior to, at the end of, and after 2 min. of recovery
from a 90 sec. PTCA occlusion of either the circumflex or the right coronary artery in 49 pts(15
F, age 66±11, 15-one vessel disease, 34-multivessel disease). Radial systolic velocity (Vel),
strain rate (SR) and strain (S) were calculated off-line for the posterior wall "at risk" segment.
Visual assessment of segmental contractility showed hypo/akinesia in 23 pts (GR I) and
normokinesia in 26 pts. (GR II). In all patients PTCA was followed by the intracoronary stent
implantation resulting in a TIMI3 flow.
Results: (see figure) .
Conclusion: In chronically ischemic myocardium Vel, SR and S can quantify and identify an
early improvement in regional myocardial contractility immediately after PTCA followed by
stenting. SR and S seem to better characterize these changes than Vel alone when compared
to M-mode grey scale thickening/thinning data.




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