Doppler Myocardial Imaging Research Articles

Strain and Strain Rate Imaging in Evaluating Left Atrial Appendage Function by Transesophageal Echocardiography

This study was planned to assess whether strain rate (Sr) and strain (S) echocardiography is a useful method for functional assessment of the left atrial appendage (LAA). Fifty-seven consecutive patients underwent a clinically indicated study. LAA late empty velocity (LAAEV) was calculated as a gold standard for left atrial appendage function. Real-time 2-dimensional color Doppler myocardial imaging data were recorded from the LAA at a high frame rate. Analysis was performed for LAA longitudinal strain rate and strain from midsegment of lateral wall of LAA. LAA strain determines regional lengthening expressed as a positive value or shortening expressed as a negative value. Peak systolic values were calculated from the extracted curve. Spearman correlation test results showed a statistically significant positive correlation was between the S, Sr variables and LAAEV (LAAEV vs S; r = 0.886, P < 0.001; LAAEV vs Sr: r = 0.897, P < 0.001, respectively). Strain and strain rate values were also significantly lower in patients with spontaneous echocardiographic contrast when compared with those without (strain; 2.42 +/- 0.98 vs 13.1 +/- 5.9, P < 0.001 and strain rate: 0.97 +/- 0.54 vs 3.34 +/- 1.15, P < 0.001, respectively). In addition, LAA strain and strain rate values were significantly lower in the patients with LAA thrombus (strain; 2.15 +/- 0.96 vs 8.35 +/- 6.9, P < 0.001, strain rate; 0.79 +/- 0.46 vs 2.30 +/- 1.48, P < 0.001, respectively). S and Sr imaging can be considered a robust technique for the assessment of the LAA systolic deformation.

Effect of dynamic myocardial dyssynchrony on mitral regurgitation during supine bicycle exercise stress echocardiography in patients with idiopathic dilated cardiomyopathy and 'narrow' QRS

Cardiac resynchronization therapy (CRT) has become an attractive therapeutic option for patients with end-stage heart failure (HF). Currently, patients are selected for CRT on ECG and on echocardiographic criteria analysed at rest. Whether the physical effort may further increase myocardial dyssynchrony is not fully established. The aim of the study was to test by the use of Doppler myocardial imaging (DMI) if dynamic left ventricular (LV) dyssynchrony during physical effort may be a determinant of dynamic mitral regurgitation in patients with dilated cardiomyopathy and 'narrow' QRS. Sixty patients (62.3 +/- 8.3 years) with idiopathic dilated cardiomyopathy and narrow QRS duration ( < 120 ms) were selected. All the patients underwent standard Doppler echo, colour DMI, supine bicycle exercise stress echocardiography, and cardiopulmonary exercise testing. Cardiac synchronicity was assessed, at rest and at peak exercise, from measurements of time intervals (Ts) between the onset of the QRS complex and the peak myocardial systolic velocity, in a six-basal-six-mid-segmental model. Standard deviation of Ts of the 12 LV segments (Ts-SD-12) was also calculated. In baseline conditions, HF patients showed an LV ejection fraction of 30.1 +/- 4%, and a significant electromechanical delay (Ts-SD-12 > or = 34.4 ms) in 20 patients (33.3%). At peak of physical exercise, a significant electromechanical delay was detected in 35 patients (58.3%), whereas in 47 patients (78.3%) exercise-induced increase in mitral valve effective regurgitant orifice (ERO) was observed. By multivariable analysis, an independent positive association between changes in Ts-SD-12 and in mitral valve ERO (P < 0.0001), as well as an independent inverse correlation of the same changes in Ts-SD-12 with LV stroke volume (P < 0.0001) were detected. In addition, changes in Ts-SD-12 were also independent determinants of peak VO(2) (P < 0.0001) during cardiopulmonary exercise testing. Colour DMI is an effective technique for assessing the severity of regional delay in activation of LV walls in HF patients with narrow QRS both at rest and during stress test. The increase in LV dyssynchrony during exercise strongly correlates with the increase in mitral regurgitation severity and with the impairment of LV stroke volume.

Associations Between Left Ventricular Myocardial Involvement and Endothelial Dysfunction in Systemic Sclerosis: Noninvasive Assessment in Asymptomatic Patients

Systemic sclerosis (SSc) is a multisystem disorder characterized by widespread vascular lesions and fibrosis of skin and distinct internal organs. Cardiac involvement is a common finding in SSc, but often clinically occult. To analyze possible associations of left ventricular (LV) myocardial function with coronary flow reserve (CFR) and endothelial function in asymptomatic patients with SSc. 30 healthy patients and 33 age- and sex-comparable asymptomatic patients classified as having either diffuse (18 patients) or limited form (15 patients) of SSc underwent standard Doppler Echo, Doppler myocardial imaging, Strain rate imaging of interventricular septum and LV lateral wall, transthoracic CFR of left anterior descending coronary vessel (after dipyridamole infusion), and brachial artery vasodilatation measurement (Vivid 7, GE Medical Systems Inc). LV diameters and ejection fraction were comparable between the two groups, while systolic pulmonary pressure (P < 0.001) was increased in SSc. By chest-CT, 15 SSc patients showed interstitial pulmonary fibrosis. Serological antibodies analysis detected anti-centromere pattern in 14 SSc patients, and anti Scl-70 in 19 patients. In SSc, LV myocardial early diastolic peak velocity, peak systolic strain rate and strain were both reduced in basal and middle interventricular septum, and in basal and middle LV lateral wall. Both CFR (P < 0.0001) and endothelial flow-mediated dilatation (P < 0.001) were significantly lower in SSc patients. By stepwise forward multivariate analyses, CFR (P < 0.001) and endothelial function (P < 0.001) were powerful independent determinants of middle LV strain. Strain rate imaging, transthoracic CFR, and brachial artery flow-mediated dilatation are valuable noninvasive and easily repeatable tools for detecting LV myocardial and vascular involvement caused by SSc. Their combined use may be therefore useful for early identifying patients with more diffused and severe form of SSc, ideally in asymptomatic cases prior to the development of severe vasculopathy, when it may be most feasible to modify the disease process by new potential therapies.

The Impact of Hypertension and Hypertension‐Related Left Ventricle Hypertrophy on Right Ventricle Function

The aim of our study is to determine the effect of hypertension and hypertension-related left ventricle hypertrophy on right ventricle (RV) morphology and function by using RV standard Doppler echocardiographic indices, myocardial Doppler imaging, and strain/strain rate imaging indices. We studied 35 patients with arterial hypertension and 30 age- and sex-adjusted control subjects who had no other pathological conditions. Standard transthoracic Doppler echocardiographical measurements, pulsed-wave tissue Doppler from tricuspid anulus (Peak systolic-st, peak early diastolic-et, peak late diastolic velocity-at), reconstructed spectral pulsed-wave tissue Doppler velocities (peak systolic-S, peak early-E, peak late diastolic velocity-A), and strain/strain rate imaging of RV free wall mid region (peak systolic strain-in, peak systolic strain rate-SR) were obtained. Age, body surface area, blood pressure, and heart rate were comparable between two groups. Hypertensive subjects had significantly increased LV end-diastolic septal and posterior wall thickness, left atrial diameter, LV mass, LV mass index, and relative wall thickness during diastole. At the level of right ventricular lateral tricuspid annulus without systolic changes, the majority of diastolic measurements were altered in hypertensives (early diastolic velocity et; 13 +/- 2 vs. 18 +/- 4 m/sec, P < 0.0001, late diastolic velocity at; 20 +/- 4 vs. 14 +/- 3 m/sec, P < 0.0001, early to late diastolic velocity ratio; 0.69 +/- 0.14 vs. 1.32 +/- 0.38, P < 0.0001). The velocity data from two-dimensional color myocardial imaging at the level of RV free wall mid region again showed altered diastolic measurements in hypertensives (E; 8.01 +/- 2.6 vs. 10.4 +/- 3.14 m/sec, P < 0.001, A; 11.5 +/- 2.6 vs. 9.12 +/- 3.7 m/sec, P < 0.0001, E/A ratio; 0.75 +/- 0.41 vs. 1.87 +/- 0.48, P < 0.00). The peak systolic strain of RV free wall mid region was significantly lower in hypertensive individuals than controls (25.666 +/- 5.64 vs. 30.03 +/- 6.78%, P < 0.05). No significant differences were found in other parameters of RV function between hypertensive and control subjects. The present study demonstrates that besides the manifest morphologic LV adaptations, significant RV functional alterations can be determined by TDI and strain/strain rate imaging in patients arterial hypertension. Both tissue velocities by TDI and strain imaging may be new tools to define and quantitate subtle change in systolic and diastolic function of right ventricular function in arterial hypertension that cannot be determined in standard echocardiographic parameters.

Left ventricular early myocardial dysfunction after chronic misuse of anabolic androgenic steroids: a Doppler myocardial and strain imaging analysis

Background: Anabolic androgenic steroids (AAS) are sometimes used by power athletes to improve performance by increasing muscle mass and strength. Recent bioptical data have shown that in athletes under the...

Myocardial and vascular dysfunction in systemic sclerosis: The potential role of noninvasive assessment in asymptomatic patients

Systemic sclerosis (SSc) is a multi-system disorder characterized by widespread vascular lesions and fibrosis of skin and distinct internal organs. The aim of the present study was to analyze possible associations of left ventricular (LV) myocardial function with coronary flow reserve (CFR) and endothelial function in asymptomatic patients with SSc. Thirty healthy subjects and 33 age- and sex-comparable asymptomatic SSc patients underwent standard Doppler Myocardial Imaging, Strain Rate (SR) Imaging of interventricular septum (IVS) and LV lateral wall, transthoracic CFR of left anterior descending coronary vessel, and brachial artery vasodilatation measurement. In SSc patients, LV myocardial early diastolic peak velocity, peak systolic SR and strain were both reduced in basal and middle IVS, and in basal and middle LV lateral wall ( p < 0.001). In addition, both CFR ( p < 0.0001) and endothelial flow-mediated dilatation ( p < 0.001) were significantly lower in SSc patients. By stepwise forward multivariate analyses, CFR ( p < 0.001) and endothelial function ( p < 0.001) were powerful independent determinants of middle LV strain of SSc patients. In conclusion, SR Imaging, transthoracic CFR and brachial artery flow-mediated dilatation are valuable non-invasive and easy-repeatable tools for detecting early LV myocardial and vascular involvement caused by SSc.

927 PDMI in evaluation of dispersion of electric impulses generated by a cardiac pacemaker dependent on the location of the ventricular lead

s S157 Eur J Echocardiography Abstracts Supplement, December 2006 927 PDMI in evaluation of dispersion of electric impulses generated by a cardiac pacemaker dependent on the location of the ventricular lead A. Drzewiecka 1; R. Mlynarski 1; E. Pilat 1; W. Kargul 1 1Medical University of Silesia, Electrocardiology Dept., Katowice, Poland New methods in echocardiography as Pulsed Doppler Myocardial Imaging (PDMI) has evolved as a well-established tool for the noninvasive evaluation of myocardial function. There are many controversies on optimal placement of the lead in the right ventricle (RV). PDMI can be a good indirect tool to evaluate dispersion of the electric impulses in the myocardium. Purpose of the study was the comparison of the track and time of dispersal of electric impulses generated by the pacemaker in the myocardium using the PDMI method dependent on location of RV lead. Methods: Bioethical agreement No NN-6501-22/05 was obtained. 45 patients were included into the trial with sinus node dysfunction (SND) syndrome, EF >50% and without contractility disturbances. All patients were divided into 3 equal groups depending on location of the RV lead: RV outflow tract (RVOT), interventricular septum (IVS) and apex. Location of the lead was confirmed by fluoroscopy and ECG. Time of dispersal of electric impulses in myocardium was evaluated by PDMI using Vivid 7 ultrasound system (GE). In each patient 2 full examinations including isovolumetric contraction time (IVC) were performed: 1 during native rhythm and 2 on artificial rhythm after reprogramming of the pacemaker on the VDD program to exclude the influence of atrial pacing. Results: Middle values of ICT differences between native and pacemaker impulse in particular walls in ms are presented in the table below. Differences in values RVOT vs apex and RVOT vs IVS were statistically significant (p<0.05). Difference in IVS vs apex were not significant (p=0,12), although it is possible to see a positive trend of apex location in the direction of the lateral and posterior wall of the LV and RV wall. Conclusion: 1. Location of the lead has influence on time of distribution of electric impulses in the myocardium. 2. RVOT can be the most optimal location of the pacemaker lead. 3. What is very surprising is that apex location seems to be a better alternative than IVS for RV pacing. Table 1. Difrences in IVC time* LEAD LOCALIZATION RV WALL IVS1 LATERAL ANTERIOR POSTERIOR in RIGHT VENTRICLE WALL WALL WALL RVOT2 12.1 ms 29.3 ms 23.6 ms 12.9 ms 22.9 ms IVS1 47.5 ms 41.7 ms 50.9 ms 42.5 ms 58.3 ms APEX 36.0 ms 39.0 ms 41.0 ms 47.0 ms 53.0 ms * IVC=Isovolumetric Contraction Time. 1 IVS=Interventricular Septum 2 RVOT=RV outflow tract

956 Is color Doppler myocardial imaging superior to conventional echocardiography in early detection of myocardial dysfunction in acromegaly?

956 Is color Doppler myocardial imaging superior to conventional echocardiography in early detection of myocardial dysfunction in acromegaly?

330 Doppler myocardial imaging in the diagnosis of early systolic left ventricular dysfunction in diabetic rats

330 Doppler myocardial imaging in the diagnosis of early systolic left ventricular dysfunction in diabetic rats

947 Mean longitudinal strain and strain rate: an index of assessing subclinical left ventricular dysfunction in hypertension

Eur J Echocardiography Abstracts Supplement, December 2006 Aim: Aim of the present study was to analyze heart function in Subclinical Hyperthyroidism (sHT) in otherwise cardiological healthy subjects both by conventional and by new methods using intramyocardial ultrasonic techniques. Material and methods: Twenty-four newly diagnosed and untreated sHT patients (20 women, mean age: 46 years) and 24 sexand age-matched healthy volunteers were studied. All subjects were submitted to conventional 2D Color-doppler echocardiography, to Pulsed Wave tissue Doppler Imaging (PWTDI) for the analysis of diastolic function, to Color Doppler Myocardial Imaging (CDMI) for the analysis of regional strain ad strain rate (SR) expression of regional myocardial deformability, and to Integrated Backscatter (IBS) for the evaluation of intrinsic contractility and tissue characterization. Results: Regional myocardial systolic strain findings were significantly higher in sHT patients when compared with controls (p<0.001). Considering diastolic SR, the early phase of diastolic SR was compromised in sHT subjects as compared with controls (p<0.001). Cyclic Variation Index (CVI), expression of intrinsic contractility, was significantly higher in sHT subjects in comparison with controls (p<0.0001). IBS values, were comparable between the 2 study groups. Conclusions: In conclusion, data of present study suggest that in young patients with sHT are present early left ventricular systolic hyperdeformability and hypercontractility and impairment of both active and passive phases of diastole but not ventricular hypertrophy or other structural alterations. To our knowledge, it is the first evidence that in sHT patients these functional modifications are present at the same time both in systolic and diastolic phase of the cardiac cycle. The intramyocardial ultrasonic techniques CDMI and IBS revealed an higher sensitivity in order to detect early functional cardiac abnormalities in sHT patients in comparison with conventional 2D-Doppler Echocardiography.

909 Single heart cycle measurement of interventricular delay by color doppler myocardial imaging in right ventricular paced patients

909 Single heart cycle measurement of interventricular delay by color doppler myocardial imaging in right ventricular paced patients

Left Ventricular Function in Normotensive Young Adults With Well-Controlled Type 1 Diabetes Mellitus

The aim of this study was to determine whether early myocardial structural and functional systolic and diastolic alterations in asymptomatic and uncomplicated patients with type 1 diabetes mellitus (DM) could be detected using the new highly sensitive echocardiographic techniques of integrated backscatter and color Doppler myocardial imaging. Forty asymptomatic and uncomplicated patients with type 1 DM and 40 gender- and age-matched normal controls were studied. All patients were analyzed by conventional and new echocardiographic techniques (integrated backscatter and color Doppler myocardial imaging). Patients with DM showed reduced systolic function compared with controls, evidenced by significantly lower peak strain, strain rates, and cyclic variation indexes at the septum (p <0.0001, <0.01, and <0.001, respectively) and at the posterior wall level (p <0.0001, <0.0001, and <0.001, respectively). On receiver-operating characteristic curve analysis, systolic strain and the cyclic variation index showed the highest discriminating power for separating patients with DM and control subjects. Neither structural or ultrastructural nor diastolic functional abnormalities were detected. On univariate regression analysis, a significant inverse correlation was found for DM duration with conventional (E/A ratio) and unconventional (tissue Doppler imaging E/A ratio) indexes of diastolic function, in the absence of any correlation for systolic function. In conclusion, highly sensitive ultrasonic techniques demonstrate evidence of left ventricular systolic dysfunction in the early stage of type 1 DM, in the absence of ultrastructural and left ventricular diastolic functional abnormalities.

Biventricular myocardial adaptation to different training protocols in competitive master athletes

Background Conflicting data have been reported about the nature (physiologic versus pathologic) of left ventricular (LV) hypertrophy in master athletes. Aim of the study To analyze LV and right ventricular (RV) myocardial function in master athletes with LV hypertrophy induced by either endurance or strength training. Methods Standard Doppler echo and colour Doppler Myocardial Imaging (DMI) of LV and of RV basal lateral walls were performed in 40 competitive master (> 45 years) endurance athletes (ATE), in 20 master strength-trained athletes (ATS) and 25 age-matched healthy sedentary subjects, all males. By use of DMI, the following parameters of myocardial function were assessed: systolic peak velocities, precontraction time, contraction time, early (E m) and late ( A m) diastolic peak velocities, E m/ A m ratio, relaxation time. Results The two groups were comparable for age, but ATS at rest showed higher heart rate, systolic blood pressure, and body surface area. LV mass index did not significantly differ between the two groups of athletes. However, ATS showed increased wall thickness and relative wall thickness, while LV stroke volume and both LV and RV end-diastolic diameters were greater in ATE. All transmitral and transtricuspid Doppler indexes were higher in ATE. DMI analysis showed in ATE higher E m and E m/ A m ratio at the level of both RV and LV lateral walls. In the overall population of athletes, linear regression models evidenced independent positive association of RV peak E m velocity with both LV stroke volume and maximal workload achieved by bicycle ergometer (both p < 0.001). Conclusions RV early diastolic myocardial function is positively influenced by preload increase in master athletes and represents an independent determinant of cardiac performance during physical effort. Therefore, colour DMI may be taken into account to distinguish different cardiac adaptation to either endurance or strength sport training in master athletes.

Ultrasonic Strain Rate and Strain Imaging of the Right Ventricle in Children Before and After Percutaneous Closure of an Atrial Septal Defect

This study examined the influence of preload alterations on systolic right ventricular (RV) velocities and deformation indices in patients with atrial septal defect (ASD). A total of 21 patients with ASD underwent 2-dimensional echocardiography and color Doppler myocardial imaging scan before and 24 hours after transcatheter ASD closure. The data were compared with those obtained from 30 healthy age-matched children. Longitudinal peak systolic velocities, peak systolic strain rate (SR), and end-systolic strain (epsilon) were calculated in the midsegment of the RV free wall and the septum. In patients with ASD, higher RV peak systolic velocities were recorded, which returned to normal values after closure of the defect. In contrast, RV deformation indices in the patients with ASD were not different from normal values. These RV indices did not change significantly after ASD closure. We found a significantly decreased septal function after percutaneous ASD closure. This may be attributed to the device within the atrial septum, affecting deformation of the interventricular septum. In conclusion, RV longitudinal systolic deformation indices were not significantly influenced by chronic ventricular volume overload and sudden abolishment of this volume overload. These findings suggest that SR/epsilon are relatively load-stable measures of contractile function in the clinical setting. In contrast, myocardial velocities are clearly load dependent.

Potential clinical perspectives of Doppler myocardial imaging and strain rate imaging during stress echocardiography

Stress echocardiography has become a common non-invasive test in patients with chest pain and known or suspected coronary artery disease, but, as with exercise electrocardiography, it shows several major limitations. Analysis of gray-scale images based on subjective visual interpretation of wall motion and thickening has considerable variability even among experts. Doppler myocardial imaging and strain rate imaging echocardiography provides additional information in comparison with conventional echocardiography. These techniques provide quantification of regional wall motion at rest and during stress. Quantification of both systolic and diastolic myocardial function by either Doppler myocardial imaging or strain rate imaging mapping during dobutamine stress test has been shown to be a feasible, accurate, non-invasive tool that should be considered to be a sensitive alternative to the present echocardiographic and scintigraphic imaging techniques for stress tests. Time consuming off-line analysis of color images is required in the present state of technology. However, these non-invasive techniques are rapidly evolving and expanding. Further refinements in signal processing and quantitative analysis are likely in the near future.

Early textural and functional alterations of left ventricular myocardium in mild hypothyroidism

The aim of the present study was to evaluate cardiac function and texture in patients with subclinical hypothyroidism (sHT) both by conventional and new ultrasonic intramyocardial tissue techniques. sHT was characterized by normal serum free tetraiodotironine and free triiodotironine levels and slightly increased serum TSH level. Twenty-four patients affected by sHT and 24 sex- and age-matched healthy volunteers were studied. All subjects were submitted to conventional two-dimensional (2D)-color Doppler echocardiography, pulsed wave tissue Doppler imaging (PWTDI) for the analysis of the diastolic function, color Doppler myocardial imaging (CDMI) for the analysis of regional strain and strain-rate and integrated backscatter (IBS) for the evaluation of intrinsic contractility and tissue characterization. The results of the present study were: (a) the detection in sHT subjects of a lower cyclic variation index (CVI) indicating an altered myocardial intrinsic contractility; (b) a higher ultrasonic myocardial reflectivity indicating an altered myocardial texture; (c) the detection of lower systolic strain and strain-rate indicating an alteration of myocardial regional deformability; (d) an initial impairment of left ventricular diastolic function indicated by a decrease of peak E mitral flow velocity and an increase of peak A mitral flow velocity. All parameters studied with conventional 2D-echo in sHT patients were comparable with controls, except for a mild alteration in diastolic function. A significant correlation among systo-diastolic modifications detected by CDMI and IBS and serum TSH levels were found. The CVI at septum, the PWDTI S-peak wave and the systolic strain at septum were inversely related to the serum TSH levels. In conclusion, the new intramyocardial ultrasonic techniques confirm and extend the previous knowledge on the effect of the sHT on the heart, allowing the detection of early ultrastructural and regional functional systolic and diastolic abnormalities.

Quantitative analysis of semi-supine exercise echocardiography - influence of age on myocardial Doppler imaging indices

Objectives — This study was performed to evaluate the feasibility of quantitative analysis of exercise echocardiography using pulsed wave Doppler myocardial imaging (DMI) and to examine the relation between age and DMI parameters at rest and during graded exercise in normal subjects.Methods and results — Seventy-two healthy volunteers were divided into three age groups (group I, age ≤ 40 years, group II, age 41 - 59 years and group III, age ≥ 60 years), and underwent a semisupine exercise echocardiogram. Peak systolic velocity (SV), time to peak SV (TPV), systolic velocity time integral (VTI) and peak diastolic velocities (VE and VA) were measured off-line.There was a heterogeneity in DMI parameters between different myocardial walls and a gradient was found between basal and mid segments. Both persisted during exercise. Group I had significantly higher TPV than groups II and III. Increase in workload was accompanied by an increase in velocities, while TPV decreased. Differences between groups persisted throughout exercise.Conclusions — Off-line measurements of DMI parameters are feasible during exercise. SV and E decline as age increases while A increases. SV already increases at low charge exercise and may serve as a quantitative marker for the detection of myocardial viability. Change of the absolute DMI velocity values during exercise may provide a better indicator of ischaemia or viability than the absolute values themselves.

Myocardial systolic strain abnormalities in patients with acromegaly: A prospective color Doppler imaging study

Heart abnormalities are frequent findings in patients with acromegaly: systolic abnormalities are considered to be secondary to diastolic changes. The aim of the study was to evaluate whether early systolic abnormalities might be revealed in acromegalic patients using the high sensitive color Doppler myocardial imaging (CDMI) technique. Twenty-two consecutive acromegalic patients with active untreated disease (ACROUNTR) were evaluated at baseline and after a 6-month course with SS analogs (SSa) (ACROSSa); 25 healthy subjects served as controls. All subjects underwent conventional 2D-color Doppler echocardiography, pulse wave tissue Doppler imaging (PW-TDI) and CDMI. Mean left ventricular (LV) ejection fraction did not differ in ACROUNTR and in controls; at variance, ACROUNTR patients had reduced mean LV diastolic function (E/A ratio: 0.96+/-0.3 vs controls: 1.6+/-0.3; p<0.002). Impairment of global LV diastolic function was confirmed by PW-TDI in ACROUNTR patients having a normal systolic function. Regional myocardial systolic strain (epsilon) and strain rate (SR) values, indices of regional systolic heart deformation, were lower in ACROUNTR [epsilonsys (S) -19.8+/-2.9 and epsilonsys (L): -17.7+/-2.2] than in controls [epsilonsys (S): -27.9+/-3.8; p<0.001 and epsilonsys (L): -25.3+/-2.6; p<0.001]. In addition, the early phase of diastolic function, evaluated using SR parameters, was impaired in acromegalic patients (p<0.005 vs controls). Strain and SR values were related to serum GH and IGF-I levels (p<0.02) and greatly improved after a 6-month course with SSa [epsilonsys (S) improved to -23.8+/-3.8 (p<0.05) and epsilonsys (L) improved to -24.7+/-2.4 (p<0.03)]. Our study confirms that ACROUNTR patients have impaired diastolic function. More important, our study clearly shows that ACROUNTR patients have an impairment of regional myocardial systolic function, which is not secondary to diastolic changes. These intramyocardial functional abnormalities improved during medical treatment of acromegaly. It is conceivable that GH-IGF-I excess has detrimental effects either on the diastolic or the systolic phases of heart function.

Doppler myocardial imaging in adult male rats: Reference values and reproducibility of velocity and deformation parameters

Limited data are available about the use of Doppler myocardial imaging (DMI) in small animals. We intend to provide reference values for velocity, strain and strain rate in a large group of healthy rats and studied the reproducibility and repeatability of these parameters. A total of 33 male Wistar rats (503+/-41g) underwent baseline transthoracic echocardiography with DMI of the anterior and inferior wall in a short-axis view using a 13MHz linear probe. Adequate tissue Doppler measurements could be obtained in 30 rats. On average 10+/-4 consecutive cycles were studied in post-processing using dedicated software (SPEQLE). Mean radial peak systolic velocity, strain and strain rate were respectively -0.8+/-0.3cm/s, 38+/-8% and 9.1+/-2.0/s in the anterior wall and 3.1+/-0.6cm/s, 49+/-10% and 13.7+/-3.7/s in the inferior wall. The reproducibility and repeatability of the DMI measurements assessed in 10 rats was good. DMI is feasible and reproducible in healthy rats. Establishing reference values opens new perspectives towards the use of strain and strain rate imaging in small rodents in the assessment of myocardial diseases.

3139: May postsystolic motion during dobutamine stress echocardiography predict the functional recovery of dysfunctional myocardium after successful percutaneous coronary intervention?

Objectives: Doppler myocardial imaging (DMI) has been suggested as a method of quantifying induced ischemia during dobutamine stress echocardiography (DSE). Postsystolic motion (PSM) detected by DMI is related with peri-infarct ischemia at DSE. We hypothesized that PSM during DSE would predict functional recovery of dysfunctional myocardium after successful percutaneous coronary intervention (PCI).