and Objectives:Tissue Doppler imaging (TDI)-derived tissue velocity (TV) and strain rate (SR) are new ultrasonic parameters for assessing the regional myocardial function by quantitatively measuring the myocardial velocity. The aim of this study was to investigate the changes of these indices after exercise, in patients with coronary artery disease (CAD), for comparison with the wall motion score index (WMSI). Subjects and Methods:Twenty-one patients with CAD and 21 normal subjects were

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... before and after an exercise stress test, using the Bruce protocol. TDI data were obtained, and analyzed offline, for peak systolic TV (PSTV) and peak systolic SR (PSSR), using a 16 segment-model. The segmental PSTV and PSSR were compared with the WMSI. Results:The number of segments with a significant increase in the PSTV or PSSR, after exercise (p<0.05), was less in the CAD patients than the normal subjects (9 vs. 14 segments, 7 vs. 10 segments, respectively). The PSTV, after exercise, progressively decreased from the base to the apex in both the normal and CAD groups, but the absolute values were significantly lower in the CAD group (base:8.44±1.28 vs. 6.56±1.6, mid: 6.31±1.18 vs. 4.26±1.25 and apex: 3.48±0.83 vs. 1.25±1.27 cm/sec, p<0.05, respectively). In the normal subjects, the PSSRs, after exercise, were uniform in all segments, whereas this was not the cases in the CAD group (p<0.05). The PSSR showed a negative correlation with the WMSI (r=-0.45, p<0.05). Conclusion:This study has shown that TV and SR can detect the ischemic myocardium with exercise stress, and objectively measure the systolic function in patients with CAD. The quantification of stress echocardiography may overcome the training requirement, and subjective nature, of conventional wall motion scoring. (Korean Circulation J 2003 ; 33 (7) : 590-598) KEY WORDS:Echocardiography, Doppler;Strain;Coronary artery disease. 서 론 국소적 심근기능의 정확한 평가는 관상동맥질환의 진 단과 치료에 매우 중요한 역할을 한다. 그러나, 심실벽 운동지수(wall motion score index, WMSI)는 심내막 편위(excursion)나 심근의 두께변화에 대한 시각적 평 논문접수일:2003년 2월 12일 심사완료일:2003년 6월 03일 교신저자:강흥선, 130-702 서울 동대문구 회기동 1번지 경희대학교 의과대학 순환기내과학교실 전화:(02) 958-8169·전송:(02) 968-1848·E-mail:aprildaum@hanmail.net