| ORIGINAL ARTICLE |
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| Year : 2016 | Volume
: 17
| Issue : 1 | Page : 1-6 |
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Diastolic abnormalities detected by velocity vector imaging in the presence of coronary ischemia: A pilot stress echocardiographic study
Brian Edward Miller1, Angel Lopez-Candales2
1 Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
2 Department of 1Cardiovascular Health and Disease, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
Correspondence Address:
Brian Edward Miller
Department of Internal Medicine, 231 Albert Sabin Way, Academic Health Center, Cincinnati, OH 45267-0542
USA
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/1995-705X.182647
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Background: The ischemic cascade has long been known to begin with diastolic dysfunction before detectable systolic abnormalities. The advent of speckle-tracking imaging and velocity vector imaging (VVI) has provided accurate and reproducible interpretation of systolic abnormalities in numerous disease processes; however, this imaging tool has been only recently been proposed for detecting diastolic abnormalities.
Methods: We analyzed pre and poststress echocardiography images of ten patients using VVI. We calculated normalized strain time (NST) as the duration strain was at least 90% of the measured peak and subtracted pre and poststress NST to calculate prolongation of NST as a sign of diastolic dysfunction. These intervals were measured from left ventricular longitudinal cine images obtained from two and 4-chamber in five patients not only with a positive stress echocardiographic response but also anatomy confirmed by coronary angiography. They were then compared to five patients without coronary artery disease (CAD).
Results: Differences in pre and poststress NST measured in the apical 4-chamber view were greater in CAD patients than without (40 ± 16 vs. 12 ± 19; P = 0.04).
Conclusions: Significant diastolic abnormalities were detected using a semi-automated VVI analysis in the poststress recovery period. A prospective study is now required in a larger number of patients to correlate the development of diastolic strain abnormalities with extent and location of CAD. |
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