Alterations in transmitral flow with dobutamine infusion do not reflect myocardial ischemia

Doppler tissue imaging (DTI) is a new technique that detects low amplitude Doppler shirts produced by myocardial wall motion. The Doppler detected velocity of the posterior wall (PW) has been shown to 15e related to the instantaneous rate of change of the posterior wall thickness. To define changes in diastolic wall n _ n _ n motion induced by . l f f ~ l " ' ~ b " ~ ~""E~--"~'~ b ' Ir II--Ov Ol ; ventricular hypertrophy, DTI was used to characterize the diastolic mt~_ ~ motion of the PW in 15 normal controls (PWthickness= 8.4 _+ 1.4ram) and in 12 ~0E" E' patients with left ventricular hy.pertrophy + ~LVH, PWttiickness= 13.7 _ 1.5mm) and normal systolic function from the parasternal long axis view. Two discrete diastolic peak velocities were identifieo in all studies (figure): earlv(E') and late (A'). The total early diastolic velocity duration (TED') and the deceleration time (DT') were measured. Pulse-wave Doppler of mitral inflow velocity (E/A ratio) were also obtained.