Influence of left ventricular size and hemodynamics on the systolic longitudinal myocardial Doppler velocity response to stress Academic Article uri icon

abstract

  • BACKGROUND:Systolic myocardial Doppler velocity accurately identifies coronary artery disease. However, these velocities may be affected by age, hemodynamic responses to stress, and left ventricular cavity size. We sought to examine the influences of these variables on myocardial velocity during dobutamine stress in patients with normal wall motion. METHODS:One hundred seventy-nine consecutive patients with normal dobutamine echocardiograms were studied. Color myocardial tissue Doppler data were obtained at rest and peak stress, and peak systolic myocardial velocity (PSV) was measured in all basal and midventricular segments. Velocities at rest and peak stress were compared with left ventricular diastolic and systolic volumes, blood pressure, heart rate, and age by Pearson correlation and interdecile analysis by use of analysis of variance. RESULTS:The only clinical variable correlating with velocity was age; PSV showed only mild correlation with age at rest (r2 = 0.01, P =.001) and peak stress (r2 = 0.02, P =.001), but the normal peak velocity was significantly different between the extremes of age (<44 years and >74 years). There was very weak correlation of PSV with systolic and diastolic blood pressure (r2 < 0.01), heart rate (r2 < 0.01), systemic vascular resistance (r2 = 0.08), and left ventricular volumes (r2 < 0.01). CONCLUSIONS:Peak systolic velocity during dobutamine stress is relatively independent of hemodynamic factors and left ventricular cavity size. The extremes of age may influence peak systolic Doppler velocities. These results suggest that peak systolic velocity may be a robust quantitative measure during dobutamine echocardiography across most patient subgroups.

publication date

  • January 2002