Potential of a new technique of Doppler tissue imaging in diagnosis of concealed coronary insufficiency

Stress (transesophageal atrial pacing) echocardiography with new doppler tissue imaging technology was used for evaluation of 31 patients 18 of whom had ischemic heart disease. Systolic and diastolic velocities of contraction and relaxation in subendocardial and subepicardial regions of the myocardium along with velocity, acceleration time and acceleration of contraction were measured at each pacing rate. In persons without ischemic heart disease progressive elevation of acceleration occurred at the account of increase in velocity on initial stages and of shortening of time on the last stages of a stress test. Velocities in subendocardial layers were higher than those in subepicardial regions throughout the whole study. In contrast, patients with coronary artery disease had equal or even inverted velocities in subendocardial and subepicardial regions and demonstrated decrease of acceleration on corresponding stages of stress test. Thus the use of a new doppler tissue imaging technology in stress echocardiography made this sensitive method of diagnosis of concealed coronary insufficiency more objective and standardized.