Document Detail


Time to onset of regional relaxation: feasibility, variability and utility of a novel index of regional myocardial function by strain rate imaging.
MedLine Citation:
PMID:  11985919     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Time to onset of regional relaxation (T(R)) has been proposed as a novel index of regional myocardial function. This study sought to prospectively establish the feasibility and variability of T(R) in healthy volunteers (CONTROL) and to examine its utility in patients with inducible ischemia (PATIENT). BACKGROUND: Strain rate imaging (SRI) depicts myocardial deformation and enables quantitation of regional myocardial function with high temporal and spatial resolution. Thus, regional mechanical events can be accurately timed with SRI. The time point of regional transition from contraction to relaxation is altered in pathologic states. METHODS: Resting mean segmental T(R) was determined in 60 subjects: 20 in the CONTROL group and 40 in the PATIENT group. T(R) was also measured at peak dobutamine stress in the PATIENT group. An automated image analysis program determined the time point of transition from regional contraction to relaxation activity, and calculated T(R), defined as the time, in milliseconds, from the electrocardiogram R-wave to this transition point. RESULTS: Automated T(R) measurements were feasible in more than 90% of the segments in CONTROL and PATIENT groups. Mean T(R) was 353 +/- 24 ms and was shorter in the mid segments compared to apical and basal segments. Intra- and interobserver variability were low (6% and 9%, respectively). In the PATIENT group, the percent decrease in T(R) during dobutamine stress was significantly higher in normal compared to ischemic segments (30% vs. 19%, respectively, p = 0.01). A percent change >20% in T(R) identified patients with an ischemic response during dobutamine infusion (sensitivity 92%, specificity 75%). CONCLUSIONS: T(R), a novel quantitative index of regional myocardial function, can be determined with low variability and satisfactory feasibility in routine clinical settings. Percent change in T(R) identifies ischemic segments during dobutamine stress echocardiography (DSE) and may allow quantitative assessment of DSE.
Authors:
Theodore P Abraham; Marek Belohlavek; Helen L Thomson; Cristina Pislaru; Bijoy Khandheria; James B Seward; Patricia A Pellikka
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  39     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2002 May 
Date Detail:
Created Date:  2002-05-02     Completed Date:  2002-05-17     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1531-7     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota 55905, USA.abraham.theodore@mayo.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Dobutamine / diagnostic use
Echocardiography, Stress
Exercise Test
Feasibility Studies
Female
Humans
Image Processing, Computer-Assisted
Male
Middle Aged
Myocardial Contraction / physiology*
Myocardial Ischemia / diagnosis*,  physiopathology
Observer Variation
Prospective Studies
Sensitivity and Specificity
Time Factors
Chemical
Reg. No./Substance:
34368-04-2/Dobutamine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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