| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
(Circulation. 2001;103:589.)
© 2001 American Heart Association, Inc.
Basic Science Reports |
Tissue Doppler Imaging Differentiates Transmural From Nontransmural Acute Myocardial Infarction After Reperfusion Therapy
From INSERM E9920 Rouen (G.D., G.P., A.C.) and Laboratoire de Physiologie Lyon-Nord (J.L., M.O.), France.
Correspondence to Geneviève Derumeaux, MD, PhD, Hôpital Charles Nicolle, 1, rue de Germont, 76000 Rouen, France. E-mail genevieve.derumeaux{at}chu-rouen.fr
Background—The evaluation of transmural extent of necrosis after acute myocardial infarction remains a major problem in clinical practice. We sought to determine whether color M-mode tissue Doppler imaging (TDI) could differentiate transmural from nontransmural myocardial infarction.
Methods and Results—Twenty-one anesthetized open-chest dogs underwent 90 or 120 minutes of left anterior descending coronary artery occlusion followed by 180 minutes of reperfusion. The transmural extension of infarct was measured by triphenyltetrazolium chloride (TTC) staining. Segment shortening in the endocardium and epicardium of the anterior and posterior walls was assessed by sonomicrometry. Regional myocardial blood flow was measured by radioactive microspheres. TDI was obtained from an epicardial short-axis view. We calculated systolic and diastolic velocities within the endocardium and epicardium of myocardial walls and the subsequent myocardial velocity gradient (MVG). TTC staining could identify 2 groups according to the transmural extent of necrosis: 15 dogs had a nontransmural (NT) necrosis (42±3% of wall thickness), and 6 dogs developed a transmural (T) infarct (81±4% of wall thickness). In both groups, ischemia resulted in a significant and similar reduction in endocardial and epicardial velocities, with a resulting low systolic MVG in the anterior wall (0.10±0.07 in NT and 0.10±0.08 s-1 in T). At 60 minutes of reperfusion, systolic MVG failed to change significantly in the transmural group (-0.20±0.09 s-1). In contrast, it increased significantly after reflow in the NT group compared with ischemic values (-0.99±0.20 versus 0.10±0.07 s-1, P<0.05).
Conclusions—TDI can differentiate transmural from nontransmural myocardial infarction early after reperfusion.
Key Words: echocardiography • imaging • myocardial infarction
This article has been cited by other articles:
 |
|
 |
|
  M. Becker, C. Ocklenburg, E. Altiok, A. Futing, J. Balzer, G. Krombach, M. Lysyansky, H. Kuhl, R. Krings, M. Kelm, et al. Impact of infarct transmurality on layer-specific impairment of myocardial function: a myocardial deformation imaging study Eur. Heart J., June 2, 2009; 30(12): 1467 - 1476. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Marcucci, R. Lauer, and A. Mahajan New Echocardiographic Techniques for Evaluating Left Ventricular Myocardial Function Seminars in Cardiothoracic and Vascular Anesthesia, December 1, 2008; 12(4): 228 - 247. [Abstract] [PDF]
|
|
|
|
 |
|
 O. Gjesdal, T. Helle-Valle, E. Hopp, K. Lunde, T. Vartdal, S. Aakhus, H.-J. Smith, H. Ihlen, and T. Edvardsen Noninvasive Separation of Large, Medium, and Small Myocardial Infarcts in Survivors of Reperfused ST-Elevation Myocardial Infarction: A Comprehensive Tissue Doppler and Speckle-Tracking Echocardiography Study Circ Cardiovasc Imaging, November 1, 2008; 1(3): 189 - 196. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Derumeaux, F. Ichinose, M. J. Raher, J. G. Morgan, T. Coman, C. Lee, J. M. Cuesta, H. Thibault, K. D. Bloch, M. H. Picard, et al. Myocardial Alterations in Senescent Mice and Effect of Exercise Training: A Strain Rate Imaging Study Circ Cardiovasc Imaging, November 1, 2008; 1(3): 227 - 234. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Becker, A. Lenzen, C. Ocklenburg, K. Stempel, H. Kuhl, M. Neizel, M. Katoh, R. Kramann, J. Wildberger, M. Kelm, et al. Myocardial Deformation Imaging Based on Ultrasonic Pixel Tracking to Identify Reversible Myocardial Dysfunction J. Am. Coll. Cardiol., April 15, 2008; 51(15): 1473 - 1481. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Weidemann, M. Niemann, S. Herrmann, M. Kung, S. Stork, C. Waller, M. Beer, F. Breunig, C. Wanner, W. Voelker, et al. A new echocardiographic approach for the detection of non-ischaemic fibrosis in hypertrophic myocardium Eur. Heart J., December 2, 2007; 28(24): 3020 - 3026. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Matre, C. A. Moen, T. Fannelop, G. O. Dahle, and K. Grong Multilayer radial systolic strain can identify subendocardial ischemia: An experimental tissue Doppler imaging study of the porcine left ventricular wall Eur J Echocardiogr, December 1, 2007; 8(6): 420 - 430. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. P. Abraham, V. L. Dimaano, and H.-Y. Liang Role of Tissue Doppler and Strain Echocardiography in Current Clinical Practice Circulation, November 27, 2007; 116(22): 2597 - 2609. [Full Text] [PDF]
|
|
|
|
|
|
B. Bijnens, P. Claus, F. Weidemann, J. Strotmann, and G. R. Sutherland Investigating Cardiac Function Using Motion and Deformation Analysis in the Setting of Coronary Artery Disease Circulation, November 20, 2007; 116(21): 2453 - 2464. [Full Text] [PDF]
|
|
|
|
 |
|
 H. Thibault, L. Gomez, E. Donal, G. Pontier, M. Scherrer-Crosbie, M. Ovize, and G. Derumeaux Acute myocardial infarction in mice: assessment of transmurality by strain rate imaging Am J Physiol Heart Circ Physiol, July 1, 2007; 293(1): H496 - H502. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Chan, L. Hanekom, C. Wong, R. Leano, G.-Y. Cho, and T. H. Marwick Differentiation of Subendocardial and Transmural Infarction Using Two-Dimensional Strain Rate Imaging to Assess Short-Axis and Long-Axis Myocardial Function J. Am. Coll. Cardiol., November 21, 2006; 48(10): 2026 - 2033. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Becker, R. Hoffmann, H. P. Kuhl, H. Grawe, M. Katoh, R. Kramann, A. Bucker, P. Hanrath, and N. Heussen Analysis of myocardial deformation based on ultrasonic pixel tracking to determine transmurality in chronic myocardial infarction Eur. Heart J., November 1, 2006; 27(21): 2560 - 2566. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. P. Sengupta, B. K. Khandheria, J. Korinek, J. Wang, and M. Belohlavek Biphasic tissue Doppler waveforms during isovolumic phases are associated with asynchronous deformation of subendocardial and subepicardial layers J Appl Physiol, September 1, 2005; 99(3): 1104 - 1111. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 O Vignaux, Y Allanore, C Meune, O Pascal, D Duboc, S Weber, P Legmann, and A Kahan Evaluation of the effect of nifedipine upon myocardial perfusion and contractility using cardiac magnetic resonance imaging and tissue Doppler echocardiography in systemic sclerosis Ann Rheum Dis, September 1, 2005; 64(9): 1268 - 1273. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. R. Sutherland Do regional deformation indexes reflect regional perfusion in all ischemic substrates? J. Am. Coll. Cardiol., October 19, 2004; 44(8): 1672 - 1674. [Full Text] [PDF]
|
|
|
|
|
|
E. Merli and G. R. Sutherland Can we quantify ischaemia during Dobutamine stress echocardiography in clinical practice? Eur. Heart J., September 1, 2004; 25(17): 1477 - 1479. [Full Text] [PDF]
|
|
|
|
|
|
C. Pislaru, C. J. Bruce, P. C. Anagnostopoulos, J. L. Allen, J. B. Seward, P. A. Pellikka, E. L. Ritman, and J. F. Greenleaf Ultrasound Strain Imaging of Altered Myocardial Stiffness: Stunned Versus Infarcted Reperfused Myocardium Circulation, June 15, 2004; 109(23): 2905 - 2910. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. A. Derumeaux Assessment of reperfusion-induced myocardial injury by echocardiography Eur. Heart J., May 1, 2004; 25(9): 714 - 715. [Full Text] [PDF]
|
|
|
|
 |
|
 K. C. Wu and J. A.C. Lima Noninvasive Imaging of Myocardial Viability: Current Techniques and Future Developments Circ. Res., December 12, 2003; 93(12): 1146 - 1158. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D Pellerin, R Sharma, P Elliott, and C Veyrat Tissue Doppler, strain, and strain rate echocardiography for the assessment of left and right systolic ventricular function Heart, November 1, 2003; 89(90003): iii9 - 17. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. K. Oh and J. Tajik The return of cardiac time intervals: The Phoenix is rising J. Am. Coll. Cardiol., October 15, 2003; 42(8): 1471 - 1474. [Full Text] [PDF]
|
|
|
|
|
|
F. Weidemann, C. Dommke, B. Bijnens, P. Claus, J. D'hooge, P. Mertens, E. Verbeken, A. Maes, F. Van de Werf, I. De Scheerder, et al. Defining the Transmurality of a Chronic Myocardial Infarction by Ultrasonic Strain-Rate Imaging: Implications for Identifying Intramural Viability: An Experimental Study Circulation, February 18, 2003; 107(6): 883 - 888. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Pislaru, C. J. Bruce, M. Belohlavek, J. B. Seward, and J. F. Greenleaf Intracardiac measurement of pre-ejection myocardial velocities estimates the transmural extent of viable myocardium early after reperfusion in acute myocardial infarction J. Am. Coll. Cardiol., November 15, 2001; 38(6): 1748 - 1756. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Jamal, J. Strotmann, F. Weidemann, T. Kukulski, J. D'hooge, B. Bijnens, F. Van de Werf, I. De Scheerder, and G. R. Sutherland Noninvasive Quantification of the Contractile Reserve of Stunned Myocardium by Ultrasonic Strain Rate and Strain Circulation, August 28, 2001; 104(9): 1059 - 1065. [Abstract] [Full Text] [PDF]
|
|