tailieunhanh - Báo cáo khoa học : Tissue Doppler imaging for the diagnosis of coronary artery disease

In clinical practice left ventricular (LV) function is commonly evaluated by 2-D and M-mode echocardiography. These modalities have significant limitations,and tissue Doppler imaging (TDI) has been introduced as a quantitative and more objective method for assessing myocardial function. The TDI modalities include myocardial velocity imaging,displacement imaging,strain rate imaging, and strain imaging (Fig. 1). This review discusses the most recent developments in TDI-based cardiac diagnostics, and discusses how TDI may be applied in the evaluation of patients with acute myocardial infarction as well as chronic coronary artery disease | Tissue Doppler imaging for the diagnosis of coronary artery disease Otto A. Smisetha Asbjorn Stoylenb and Halfdan Ihlena Purpose of review Tissue Doppler imaging TDI is a diagnostic method that provides quantitative data about myocardial function. The present review discusses the most recent developments in the application of TDI in coronary artery disease. Recent findings The most widely used TDI modality is velocity imaging and systolic function is measured as peak velocity during LV ejection. Several recent studies show that TDI measurements during the LV isovolumic phases provide unique information regarding myocardial dysfunction. Since velocity imaging is confounded by influence from velocities in other segments the TDI-based modalities strain- and strain rate imaging SRI have been introduced to measure regional shortening fraction and shortening rate respectively. Velocity imaging during stress echocardiography has been validated clinically and appears equivalent but not superior to conventional visual assessment of grey scale images. Potentially more comprehensive evaluation that includes the use of SRI may improve the diagnostic power of TDI further. Preliminary reports suggest that TDI may have an important role in the assessment of viability in acute coronary occlusion but this needs to be demonstrated in appropriately designed clinical trials. Summary At the present time tissue Doppler velocity imaging can be recommended for clinical use especially the pulsed mode. Strain rate imaging may be useful as additional imaging but needs further refinement before it is ready for routine clinical use. Keywords echocardiography tissue Doppler coronary artery disease acute myocardial infarction Curr Opin Cardiol 19 421-429. 2004 Lippincott Williams Wilkins. aDepartment of Cardiology Rikshospitalet University Hospital Oslo Norway and bNTNU Trondheim Norway Correspondence to Otto A. Smiseth Department of Cardiology Rikshospitalet N-0027 Oslo Norway Tel 4723070000 .

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