SEGMENTAL COLOR DOPPLER MYOCARDIAL IMAGING DERIVED PRE-EJECTION VELOCITIES ARE NOT CLINICALLY USEFUL IN THE ASSESSMENT OF POST-INFARCTION SCAR TRANSMURALITY

Tomas Skala, Martin Hutyra, David Horak, Milos Taborsky
2010 Biomedical Papers of the Faculty of Medicine of Palacky University  
Introduction. The presence of a velocity in isovolumic contraction phase (Vivc) evaluated using tissue Pulse wave Doppler myocardial imaging (PWDMI) correlates with a transmural extent of scar after myocardial infarction. The possible clinical usefulness of Vivc evaluated using color Doppler myocardial imaging (CDMI) in detection of a scar after myocardial infarction extent in patients with coronary heart disease (CHD) and low LV systolic function remains to be clarified. Patients and methods.
more » ... ients and methods. 57 patients with CHD (average LVEF 33.5±5%), examined echocardiographicaly (17-segment LV model, 689 segments evaluated) and by cardiac magnetic resonance. All segments were scanned for Vivc presence using CDMI. Vivc presence/absence was correlated with signs of a scar after MI in all segments and in akinetic segments separately. Results. We found significantly larger values of wall thickness (8.2±2,2 vs. 7.1±1.9, p<0.0001), significantly lower values of average late enhancement (LE) extent (1.32±1.78 vs. 1.66±1.98, p=0.041) and LE/wall thickness ratio (20.1±29.8 vs. 29.6±36.7, p=0.008) in segments with present Vivc. Vivc presence in a segment with an abnormal wall motion had a sensitivity of 72.9% and a specificity of 35.7% in recognizing a segment without a transmural scar (LE/ wall thickness ratio ≤75%). Vivc absence in a segment with an abnormal wall motion had a sensitivity of 72.7% and a specificity of 41.2% in recognizing a segment with a transmural scar (LE/wall thickness ratio ≥75%). Conclusions. Isovolumic velocities evaluation assessed using color Doppler myocardial imaging is not applicable in a real-world clinical setting. The presence or absence of a velocity pattern during LV isovolumic contraction is not useful in in the assessment of a post-infarction scar transmurality.
doi:10.5507/bp.2010.038 pmid:21048812 fatcat:gnerigx6hbhvbah45ynnsn7gg4