Rachna Seth1, Sandeep Seth, Veena Kalra. 1. Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India. drrachnaseth@yahoo.co.in
Abstract
OBJECTIVE: To study role of Tissue Doppler imaging (TDI) in identification of cardiomyopathy before development of ventricular dysfunction. METHODS: Twenty-five patients with Duchenne's (DMD) and 10 with Becker's (BMD) muscular dystrophy along with 20 controls were evaluated using TDI. RESULTS: Pulse Tissue Doppler signals of the lateral left ventricle wall (lateral mitral annulus) revealed reduced systolic velocities in the DMD patients (mean +/- SD: 7.8 +/- 1.1 cm/sec vs. 8.6 +/- 1.1 cm/sec in controls) in patients of DMD. 60% of the non ambulatory DMD (ejection fraction 45+/-9%) patients had mild LV dysfunction and reduced systolic velocities (6.96 +/- 1.7 cm/sec, p<0.05 vs controls). The ambulatory DMD patients also had reduced systolic velocities (7.8 +/- 1.1 cm/sec) though ejection fraction was normal. Reduced tissue Doppler systolic velocities in the ambulatory DMD patients with normal conventional echocardiography would suggest that perhaps some of these patients (20% had velocities less than Mean - 2 SD of controls) have early myocardial dysfunction (picked up only as abnormal myocardial velocities). CONCLUSIONS: TDI picked up systolic dysfunction of the lateral wall in DMD even when overall LV function was normal conventional echocardiography. Tissue Doppler imaging is a useful technique to pick up early ventricular dysfunction and should be evaluated in larger studies and also with other techniques like magnetic resonance imaging.
OBJECTIVE: To study role of Tissue Doppler imaging (TDI) in identification of cardiomyopathy before development of ventricular dysfunction. METHODS: Twenty-five patients with Duchenne's (DMD) and 10 with Becker's (BMD) muscular dystrophy along with 20 controls were evaluated using TDI. RESULTS: Pulse Tissue Doppler signals of the lateral left ventricle wall (lateral mitral annulus) revealed reduced systolic velocities in the DMDpatients (mean +/- SD: 7.8 +/- 1.1 cm/sec vs. 8.6 +/- 1.1 cm/sec in controls) in patients of DMD. 60% of the non ambulatory DMD (ejection fraction 45+/-9%) patients had mild LV dysfunction and reduced systolic velocities (6.96 +/- 1.7 cm/sec, p<0.05 vs controls). The ambulatory DMDpatients also had reduced systolic velocities (7.8 +/- 1.1 cm/sec) though ejection fraction was normal. Reduced tissue Doppler systolic velocities in the ambulatory DMDpatients with normal conventional echocardiography would suggest that perhaps some of these patients (20% had velocities less than Mean - 2 SD of controls) have early myocardial dysfunction (picked up only as abnormal myocardial velocities). CONCLUSIONS: TDI picked up systolic dysfunction of the lateral wall in DMD even when overall LV function was normal conventional echocardiography. Tissue Doppler imaging is a useful technique to pick up early ventricular dysfunction and should be evaluated in larger studies and also with other techniques like magnetic resonance imaging.
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