Doppler Tissue Imaging Of Pre-Ejectional Left Ventricular Wall Dynamics In A Normal Subjects.

Pre-ejectional left ventricular wall motion has been demonstrated clinically by angiography. Intramyocardial wall velocities generated by cardiac contraction may be measured by Doppler tissue imaging. The aim of this study was to detect pre-ejectional wall motion and to analyse its sequencer. A long axis M Mode with simultaneous septal and posterior wall imaging was performed in 11 normal subjects (age 37 +/- 15 years) with velocity analysis between the electrocardiographic Q wave and the onset of ejection by digitised analysis between the electrocardiographic Q wave and the onset of ejection by digitised images with automatic velocity extraction (3.8 ms) along a horizontal subendocardial line. The total duration of the pre-ejectional periods in conventional and Doppler tissue imaging are compared. Oscillatory velocimetric apearances with alternate colours of adjacent bands in each wall and a mirror image between walls was observed. The mean and peak velocities of the first four bands were significantly different between the walls (p < 0.001) as were the absolute Values between bands 2 (p < 0.02) and 3 (p < 0.006).The duration of band 2, related to motion mainly towards the center of the ventricular chamber exceeded that of the adjacent bands (septum p < 0.02, posterior wall p < 0.001). The correlation coefficient for total duration of the pre-ejectional period between Doppler tissue imaging and conventional Doppler was 0.83, p < 0.05 for the interventricular septum and 0.76, p < 0.04 for the posterior was. The authors conclude that regional pre-ejectional wall motion can be recorded. During isovolumic contraction, there is motion predominantly towards the center of the left ventricular chamber of the two walls, confirming previous angiographic findings. its timing suggests that wall motion precedes the increase in ventricular pressure.