Determinants of tissue Doppler measures of regional diastolic function during XXXX stress echocardiography.

@entity1 @entity452 @entity63 @entity4346 @entity453 @entity67
BACKGROUND: @entity67 induced by @entity63 may alter transmitral blood flow, but this reflects global ventricular function, and pseudonormalization may occur with increased preload. Tissue Doppler may assess regional diastolic function and is relatively load-independent, but limited data exist regarding its application to stress testing. We sought to examine the stress response of regional diastolic parameters to @entity452 echocardiography (DbE). METHODS: Sixty-three @entity1 underwent study with DbE: 20 with low probability of @entity453 ( @entity453 ) and 43 with @entity453 who underwent angiography. A standard DbE protocol was used, and segments were categorized as @entity63 , scar, or normal. Color tissue Doppler was acquired at baseline and peak stress, and waveforms in the basal and mid segments were used to measure early filling (Em), late filling (Am), and E deceleration time. Significant @entity453 was defined by stenoses >50% vessel diameter. RESULTS: Diastolic parameters had limited feasibility because of merging of Em and Am waves at high heart rates and limited reproducibility. Nonetheless, compared with normal segments, segments subtended with significant stenoses showed a lower Em velocity at rest (6.2 +/- 2.6 cm/s vs 4.8 +/- 2.2 cm/s, P <.0001) and peak (7.5 +/- 4.2 cm/s vs 5.1 +/- 3.6 cm/s, P <.0001). Abnormal segments also showed a shorter E deceleration time (51 +/- 27 ms vs 41 +/- 27 ms, P =.0001) at base and peak. No changes were documented in Am. The same pattern was seen with segments identified as @entity63 with wall motion score. However, in the absence of @entity63 , segments of @entity1 with @entity4346 showed a lower Em velocity, with blunted Em responses to stress. CONCLUSION: Regional diastolic function is sensitive to @entity63 . However, a number of practical limitations limit the applicability of diastolic parameters for the quantification of stress echocardiography.
