Usefulness of myocardial tissue Doppler echocardiography to evaluate left ventricular dyssynchrony before and after biventricular pacing in patients with idiopathic dilated cardiomyopathy

Myocardial tissue Doppler echocardiography (TDE) has been proposed as a tool for the assessment of diastolic function. Controversy exists regarding whether TDE measurements are influenced by preload. In this study, left ventricular volume and high-fidelity pressures were obtained in eight closed-chest dogs during intermittent caval occlusion. The time constant of isovolumic ventricular relaxation (τ) was altered with varying doses of dobutamine and esmolol. Peak early diastolic myocardial ( E m) and transmitral ( E) velocities were measured before and after preload reduction. The relative effects of changes in preload and relaxation were determined for E m and compared with their effects on E. The following results were observed: caval occlusion significantly decreased E (Δ E = 16.4 ± 3.3 cm/s, 36.6 ± 13.7%, P < 0.01) and E m (Δ E m = 1.3 ± 0.4 cm/s, 32.5 ± 26.1%, P < 0.01) under baseline conditions. However, preload reduction was similar for E under all lusitropic conditions ( P = not significant), but these effects on E m decreased with worsening relaxation. At τ < 50 ms, changes in E m with preload reduction were significantly greater (Δ E m = 2.8 ± 0.6 cm/s) than at τ = 50–65 ms (Δ E m = 1.2 ± 0.2 cm/s) and at τ >65 ms (Δ E m = 0.5 ± 0.1 cm/s, P < 0.05). We concluded that TDE E m is preload dependent. However, this effect decreases with worsening relaxation.

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Improvement of Left Ventricular Dyssynchrony by Carvedilol Therapy in Patients with Idiopathic Dilated Cardiomyopathy: Analysis Using Strain Echocardiography

Journal of Cardiac Failure ◽

10.1016/j.cardfail.2005.08.248 ◽

2005 ◽

Vol 11 (9) ◽

pp. S301

Author(s):

Yasuhiko Takemoto ◽

Takeshi Hozumi ◽

Kenichi Sugioka ◽

Yoshiki Matsumura ◽

Yasuhiro Takagi ◽

...

Keyword(s):

Dilated Cardiomyopathy ◽

Left Ventricular ◽

Idiopathic Dilated Cardiomyopathy ◽

Left Ventricular Dyssynchrony ◽

Ventricular Dyssynchrony ◽

Strain Echocardiography

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New aspects on the assessment of left ventricular dyssynchrony by tissue Doppler echocardiography: comparison of myocardial velocity vs. displacement curves

The International Journal of Cardiovascular Imaging ◽

10.1007/s10554-009-9484-8 ◽

2009 ◽

Vol 25 (7) ◽

pp. 699-704 ◽

Cited By ~ 1

Author(s):

N. Bogunovic ◽

D. Hering ◽

F. van Buuren ◽

D. Welge ◽

B. Lamp ◽

...

Keyword(s):

Doppler Echocardiography ◽

Tissue Doppler ◽

Left Ventricular ◽

Tissue Doppler Echocardiography ◽

Left Ventricular Dyssynchrony ◽

Myocardial Velocity ◽

Ventricular Dyssynchrony

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Abstract 4827: Role of Left Ventricular Dyssynchrony in Functional Mitral Regurgitation in Patients with Dilated Cardiomyopathy: A Comparison Study with Geometric Parameters of Mitral Apparatus Estimated with 3d Echocardiography

Circulation ◽

10.1161/circ.118.suppl_18.s_945-a ◽

2008 ◽

Vol 118 (suppl_18) ◽

Author(s):

Woonggil Choi ◽

Soohyun Kim ◽

Seongill Woo ◽

Deahyuk Kim ◽

Keumsoo Park ◽

...

Keyword(s):

Mitral Regurgitation ◽

Dilated Cardiomyopathy ◽

Multivariate Regression Analysis ◽

Tissue Doppler ◽

Left Ventricular ◽

Geometric Parameters ◽

Functional Mitral Regurgitation ◽

Left Ventricular Dyssynchrony ◽

Lv Dyssynchrony ◽

Mitral Apparatus

Objective: Functional mitral regurgitation (FMR) occurs commonly in patients with dilated cardiomyopathy (DCM). The aim of this study was to compare the roles of Left Ventricle(LV) dyssynchrony and geometric parameters of mitral apparatus as determinants of FMR in patients with DCM. Methods: Fourteen DCM patients without FMR and 15 DCM patients with FMR (ERO = 0.11 ± 0.029 cm 2 ) were enrolled. Effective regurgitant orifice (ERO) area and tissue Doppler-derived dyssynchrony index (DI: the standard deviation of time to peak myocardial systolic contraction of eight segments) were measured. The estimated DIs were corrected by the cycle length (CL) of each patient (cDI (%) = DI/CL*100). Using real-time 3D echocardiogrphy, mitral tenting area (MVT) and the degrees of displacement of anterior (APMD) and posterior (PPMD) papillary muscles were estimated. All geometric measurements were corrected (c) by the height of each patient. Results: There was no significant (p > 0.05) difference in LV Ejection Fraction and cLVEDV between two patient groups. cDI, cMVT, cAPMD and cPPMD significantly (p < 0.05) increased in the patient with FMR comparing with those in patients without FMR. cDI (r = 0.42), cMVT (r = 0.74), cAPMD (r = 0.63) and cPPMD (r = 0.64) showed significant (p < 0.05) correlations with ERO. cMVT was found to the strongest independent predictor of ERO with multivariate regression analysis, whereas cDI did not enter into the model. Conclusions: The degree of MV tenting rather than LV dyssynchrony was found to be the main determinant of FMR in DCM. However LV dyssynchrony also has a minor independent association with FMR.

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Survival and echocardiographic evaluation of dogs with idiopathic dilated cardiomyopathy treated with carvedilol

Arquivo Brasileiro de Medicina Veterinária e Zootecnia ◽

10.1590/s0102-09352010000300009 ◽

2010 ◽

Vol 62 (3) ◽

pp. 555-563 ◽

Cited By ~ 2

Author(s):

E.C. Soares ◽

G.G. Pereira ◽

L.C. Petrus ◽

M. Leomil Neto ◽

F.L. Yamaki ◽

...

Keyword(s):

Dilated Cardiomyopathy ◽

Ventricular Remodeling ◽

Left Ventricular ◽

Idiopathic Dilated Cardiomyopathy ◽

P Value ◽

Echocardiographic Evaluation ◽

Before And After ◽

Group A ◽

The Stability ◽

Group B

Sixty dogs with idiopathic dilated cardiomyopathy were randomly treated with traditional therapy - digitalis, diuretics, angiotensin-converting inhibitors - (group A) or treated with these drugs plus carvedilol (group B). Echocardiographic variables were measured before and after 3, 13, 26, and 52 weeks of treatment or until death. Comparisons between groups and time were performed. No significant differences between groups were found in the most of the echocardiographic variables. The left ventricular end-systolic diameter indexed to body surface area (LVESDi) increased significantly in the group A dogs compared to the group B animals. The survival of groups A and B dogs were not different (P-value=0.1137). In conclusion, the stability of the LVESDi observed in the group treated with carvedilol may represent the beneficial effect over the ventricular remodeling.

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