[Analysis and quantification of longitudinal contraction of the left ventricle in myocardial infarction. Value of Doppler myocardial tissue imaging].

The authors compared the results of conventional 2D echocardiography and those of Doppler tissue imaging in 30 patients in the intensive care unit for acute pulmonary myocardial infarction and 10 normal control subjects, to assess the longitudinal contraction of the left ventricle. Echocardiography was performed in the apical 2 and 4 chamber views to analyse the septal, lateral, posterior and anterior left ventricular walls. Each wall was divided into 3 segments: basal, median and apical. Each segment was scored: 1-normo or hyperkinetic, 2-hypokinetic, 3-akinetic and 4-dyskinetic. Doppler tissue imaging provided the maximum instantaneous velocities in systole and diastole in each segment. In control subjects, the myocardial velocities decreased significantly from the base to the apex, resulting in a systolic and diastolic pressure gradient with each wall between the base and the apex. In patients with myocardial infarction, the myocardial velocities were decreased compared with the control group. Moreover, the myocardial velocity gradient between the base and apex was significantly reduced in the hypo and akinetic walls, both in systole and diastole. These results show that, in myocardial infarction, the longitudinal left ventricular contraction is abnormal and may be analysed and quantified by new indices of myocardial systolic and diastolic function, provided by Doppler tissue imaging.