[Evaluation of left ventricular diastolic function with tissue doppler echocardiography (TDI) in patients after angioplasty of the artery responsible for infarction]

Abstract

To assess the ability of left ventricular (LV) diastolic function to improve following angioplasty of an infarct related artery (IRA), 39 patients were evaluated with the Tissue Doppler Imaging (TDI). Studied group comprised of 30 males and 9 females (age 53.3 +/- 8.3 yrs), who were 1 to 6 months after myocardial infarction (MI). They qualified for angioplasty of IRA if dobutamine stress echocardiography proved viability of the affected myocardium. Regional wall diastolic function was assessed by TDI 1 day before (exam 1), 1-3 days (exam 2) and 30 days (exam 3) after successful angioplasty. TDI myocardial diastolic velocities (Em and Am wave, Em/Am ratio) and time intervals (isovolumic relaxation time IVRT, rapid filling time RFT, atrial filling time AFT) were measured in the long axis of posterior (20 pts), anterior (17 pts) and lateral (2 pts) walls. Regional E wave velocity was increased between exam 1 and 3 (6.0 +/- 1.5 cm/s vs 6.7 +/- 1.7 cm/s, p < 0.05), the same as Em/Am ratio (1.0 +/- 0.4 vs 1.3 +/- 0.9, p < 0.05). There was no significant change in Am wave velocity. The regional RFT was prolonged between exam 1 and 2 (151 +/- 39 ms vs 170 +/- 30 ms, p < 0.01), whereas IVRT was shortened (103 +/- 21 ms vs 87 +/- 20 ms, p < 0.001).

Conclusions: Regional diastolic function showed improvement as assessed by TDI after successful angioplasty of IRA. TDI allows the assessment of regional diastolic performance and its dynamics.