Superiority of the Tissue Doppler Imaging Technique on Determination of the Myocardial Dysfunction in Patients with NonQ-wave Myocardial Infarction at Early Term

After Q wave myocardial infarction (MI), decreased tissue Doppler velocity gradient in the effected segments was well known. The aim of this study demonstrates the myocardial dysfunction without segmental dysfuntion by using tissue Doppler echocardiograpy in patients with nonQ-wave MI.
METHODS
As the study group (SG) 25 pts with nonQ-wave MI and without segmental dysfunction (18 F, 7 M; mean age 57±10) and as a control group (CG) 20 pts without coronary heart disease (14 F, 6 M; mean age 51(15) were included the study. Systolic velocity gradient (Sm), the time from the electrocardiographic Q wave to the peak of the Sm (Q-Sm), early and late diastolic velocity gradients of mitral lateral anulus were measured by tissue Doppler imaging. During the catheterization, the ejection fraction (EF) and -Dp/Dt were calculated.
RESULTS
EF and -Dp/Dt were similar in both groups. When SG and CG compared, Sm (6.7±1.9 vs 9.8±2.9 cm/sec, p<0.00001) and Em/Am were lower (0.9±0.4 vs 1.3±0.7, p=0.013) and Q-Sm longer (172.9±29.8 vs 141.2±30.9 msec, p=0.0003) in the SG. When correlated for Sm and Q-Sm with EF, moderate correlations were seen in both groups (in the SG 0.59, -0.55 and in the CG 0.70 and -0.61, respectively). In the SG and CG, moderate correlations were seen between Em/Am and -Dp/Dt (0.66 and 0.62, respectively).
CONCLUSIONS
Systolic and diastolic parameters which provided by using the tissue Doppler imaging mentioned above, have moderate correlations between them selves and invasive measurements in patients with nonQ-wave MI. Although invasive systolic and diastolic measurements were normal, changes in the systolic and diastolic myocardial velocity gradients, showed by tissue Doppler imaging, are early noninvasive determinants of myocardial dysfunction.