Timur TİMURKAYNAK, Gülten TAÇOY, Yusuf TAVİL, Sedat TÜRKOĞLU, Atiye ÇENGEL, Mustafa CEMRİ, Murat ÖZDEMİR

Miyokart iskemisinin dobutaminli doku doppler ekokardiyografi ile değerlendirilmesi

Amaç: Bu çalışma, dobutaminli atım dalgalı doku Doppler ekokardiyografinin, iskemik ve iskemik olmayan miyokardiyal segmentlerin ayrımında kullanılabilirliğiniaraştırmak için yapıldı. Gereç ve Yöntemler: Çalışma, istirahat ekokardiyografilerinde sol ventrikül seg- menter kinezi bozukluğu olmayan ve klinik olarak koroner anjiyografi endikasyo- nu konulan 18 hasta (yaş ortalaması 56.4±7.7; 7 kadın, 11 erkek) üzerinde yapıldı.Hastalar kateterizasyondan önceki 24 saat içinde ekokardiyografi laboratuvarınaalındı. Apikal aküstik pencereler kullanılarak dinlenme ve pik dobutamin infüzyonu sırasında, mitral anülüs, bazal ve orta segmentlerden sistolik doku hızları eldeedildi. Ölçülen hızlar kullanılarak dobutamin pik infüzyonu sırasındaki sistolik hızınistirahat ölçümüne göre artış yüzdesi (S%) hesaplandı. Koroner arter hastalığı en azbir majör epikardiyal arterde %50 veya daha fazla stenoz olması olarak tanımlandı.Miyokardiyal segmentler 3 gruba ayrıldı. Koroner anjiyografisi normal olan kimselere ait segmentler Grup 1 sayıldı. Koroner arter hastalığı olanların segmentleri,normal koroner tarafından kanlanıyorsa Grup 2, stenoz olan koroner arter tarafındankanlanıyorsa Grup 3 olarak sınıflandırıldı. Bulgular: Çalışmamızda S% Grup 1’de 79.0±39.2, Grup 2’de 76.1±25.3, Grup 3’de49.2±23.1 olarak bulundu (F=19.175, p

Assessment of myocardial ischemia using dobutamine stress pulsedwave tissue doppler echocardiographyabstract

Objective: To evaluate the utility of dobutamine stress pulsed-wave tissue Doppler echocardiography in differentiating ischemic myocardial segments from nonischemic ones. Materials and Methods: Eighteen patients (mean age 56.4±7.7, 11 male) who hadnormal left ventricular regional wall motion analysis at rest and undergoing coronaryangiography for clinical reasons were included. In each subject, mitral annular, basal,and mid-segment systolic velocities was obtained from the apical echocardiographicwindows at rest and during peak dobutamine infusion. Two systolic velocity measurements were used to calculate the percent increase in systolic velocity (S%) duringpeak dobutamine infusion relative to rest measurements. Coronary artery diseasewas defined as ≥50 percent stenosis in at least one major epicardial coronary artery. The myocardial segments were classified into 3 groups. The cardiac segmentsbelonging to patients with normal coronary angiograms were Group 1. The cardiacsegments belonging to patients with coronary artery disease were classified as Group 2 if the segment was supplied by a normal coronary artery or Group 3 if it wassupplied by a stenosed artery. Results: S% values in Groups 1, 2, and 3 were 79.0±39.2, 76.1±25.3, and 49.2±23,respectively (F=19.175, p

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