Measurement of Left Ventricular Diastolic Function with Color M-mode Echocardiography in Patients with Acute Coronary Syndrome

Han, Juyup; Park, Yongwhi; Yang, Donghun; Seo, Youngbae; Park, Hunsik; Chae, Shungchull; Jun, Jaeeun; Park, Ehyun

Abstract

BACKGROUND: Color M-mode doppler echocardiography has been suggested as a new noninvasive technique for assessing left ventricular diastolic function. The present study was performed to define the feasibility and value of color M-mode echocardiography for the assessment of left ventricular diastolic function in patients with acute coronary syndrome.
METHODS
Thirty six patients with acute myocardial infarcion and twenty three patients with unstable angina were included (M/F=41/18, 61+/-12.2 years). Doppler study was performed using ATL HDI-3000 within 24 hours after the attack. In color M-mode study, ROP was measured with 'Front wave method' and 'Baseline shift method'. The patients were grouped into three groups based on E/A ratio and deceleration time (DT) in transmitral flow and S/D ratio in pulmonary venous flow; Group I=Normal pattern (E/A>1, S/D>1, DT>140 ms), Group II=Impaired relaxation pattern (E/A<1, DT>140 ms) and Group III=Pseudonormal/Restrictive pattern (E/A>1.5, S/D<1, with or without DT< or =140 ms). RESULT: Twenty two, thirty four, and three patients were assigned to Group I, II, III, respectively. The ROP could be measured with 'Front wave method' in 50 patients (84.7%), but with 'Baseline shift method' only in 19 patients (32.2%). ROP with 'Front wave method' was 65+/-25.7, 61+/-35.6, 71+/-35.2 cm/sec in Group I, II, III, respectively. There was no statistically significant difference in the value of ROP between group I and II (p>0.05).
CONCLUSION
The ROP seems not to reflect the diastolic function in acute coronary syndrome, although it is measurable with the 'Front wave method' in most cases. The measurement of the ROP with 'Baseline shift method' is not feasible in the patients with acute coronary syndrome.