Pre-ejectional left ventricular wall motions studied on conscious dogs using Doppler myocardial imaging: relationships with indices of left ventricular function.

Duration of the pre-ejection period is a sensitive index of myocardial function. Our purpose was to document normal pre-ejectional left ventricular (LV) wall motions at rest and under dobutamine using Doppler myocardial imaging (DMI), and to correlate posterior wall velocities with indices of LV systolic function. M-mode recordings of both walls were imaged on eight conscious dogs chronically instrumented. Subendocardial pre-ejectional velocities were digitized and measured every 3.8 ms. DMI analysis consisted of sign recognition, velocity measurement, duration and timing from the Q wave of the electrocardiogram. Isovolumic contraction time (Ict) was represented by the time interval from onset to peak of the first derivative of LV pressure. Conventional Doppler labelling of velocity signs, positive toward and negative away from the transducer, was applied to the direction of encoded wall motions. For physiological understanding, wall motions of both walls were also labelled inward and outward with respect to the left ventricular cavity center. In each wall, PEP was shown as several colored strips, each strip representing the period of time that the wall was moving in one direction. Changes in velocity sign corresponding to changes in direction of motion were opposed in each wall (p < 0.001), featuring successive inward and outward wall motions. There was a markedly sustained inward motion during Ict. Its velocity amplitude increased with dobutamine. There was a positive correlation between velocities of the inward motion contemporaneous of Ict and ejection fraction (r = 0.72, p < 0.003). Values of Ict respectively drawn from DMI and from hemodynamics were also significantly correlated (r = 0.85, p < 0.007). Thus, the inward motion evidenced by DMI during Ict appears promising to assess myocardial function and effect of drugs.