CLINICAL STUDY
Relation of tissue Doppler derived myocardial velocities to myocardial structure and beta-adrenergic receptor density in humans
Kesavan Shan, MD*,
Roger J. Bick, PhD ,
Brian J. Poindexter, MSc,
Sarah Shimoni, MD*,
George V. Letsou, MD ,
Michael J. Reardon, MD,
Jimmy F. Howell, MD,
William A. Zoghbi, MD, FACC* and
Sherif F. Nagueh, MD, FACC*
* Department of Medicine, Section of Cardiology, Baylor College of Medicine, USA
Department of Surgery, Baylor College of Medicine, USA
Department of Pathology, University of Texas Medical School, Houston, Texas, USA
Manuscript received October 19, 1999;
revised manuscript received January 17, 2000,
accepted April 19, 2000.
Reprint requests and correspondence: Dr. Sherif F. Nagueh, 6550 Fannin Street, SM-1246, Houston, Texas 77030-2717
sherifn{at}bcm.tmc.edu
OBJECTIVES
We sought to evaluate the relation of segmental tissue Doppler (TD) velocities to both the regional amount of interstitial fibrosis and the myocyte beta-adrenergic receptor density in humans.
BACKGROUND
The systolic myocardial velocity (Sm) and early diastolic myocardial velocity (Em) acquired by TD are promising new indexes of left ventricular function. However, their structural and functional correlates in humans are still unknown.
METHODS
Ten patients with coronary artery disease underwent echocardiographic examination including TD imaging, along with transmural endomyocardial biopsy at the time of coronary bypass surgery (two biopsies per patient for a total of 20 specimens). The specimens were analyzed for percent interstitial fibrosis and beta-adrenergic receptor density.
RESULTS
Normal segments (n = 8) had a higher beta-adrenoceptor density (2,280 ± 738 vs. 1,373 ± 460, p = 0.03) and a lower amount of interstitial fibrosis (13 ± 3.3% vs. 28 ± 11.5%, p = 0.002) than dysfunctional segments (n = 12). Myocardial systolic velocity and Em were also significantly higher (9.5 ± 2.7 vs. 5.9 ± 1.8 cm/s, p = 0.025 and 11.3 ± 2.8 vs. 6.4 ± 2.1 cm/s, p = 0.002, respectively) in normal segments. A significant relationship was present between Em and the beta-adrenergic receptor density (r = 0.78, p < 0.001) and percent interstitial fibrosis (r = –0.7, p = 0.0026), which together accounted for 81% of the variance observed in Em. Likewise, a significant relationship was present between Sm and the beta-adrenergic receptor density (r = 0.68, p < 0.001) and the percent interstitial fibrosis (r = –0.66, p = 0.004) and together accounted for 62% of the variance observed in Sm.
CONCLUSIONS
Systolic myocardial velocity and Em are strongly dependent on both the number of myocytes and the myocardial beta-adrenergic receptor density.
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Abbreviations and Acronyms
| | Am | = late diastolic velocity | | CAD | = coronary artery disease | | Em | = early diastolic velocity | | Sm | = myocardial systolic velocity | | TD | = tissue Doppler | | TEE | = transesophageal echocardiography |
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ehm166v1.
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|
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|
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|
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|
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|
|
|
|
|
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|
|
|
|
|
|
|
M. C. C. Borges, R. C.R. Colombo, J. G. F. Goncalves, J. d. O. Ferreira, and K. G. Franchini
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|
|
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|
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|
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D. Vinereanu, E. Nicolaides, A. C. Tweddel, and A. G. Fraser
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M. Kozakova, A. G. Fraser, S. Buralli, A. Magagna, A. Salvetti, E. Ferrannini, and C. Palombo
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45(4):
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|
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|
|
|
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C. Y. Wong, T. O'Moore-Sullivan, R. Leano, N. Byrne, E. Beller, and T. H. Marwick
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|
|
|
|
|
|
|
C J McMahon, S F Nagueh, R S Eapen, W J Dreyer, I Finkelshtyn, X Cao, B W Eidem, L I Bezold, S W Denfield, J A Towbin, et al.
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|
|
|
|
|
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B Lind, J Nowak, P Cain, M Quintana, and L.-A Brodin
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109(11):
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|
|
|
|
|
|
|
A D'Andrea, P Caso, B Sarubbi, M D'Alto, M Giovanna Russo, M Scherillo, M Cotrufo, and R Calabro
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March 1, 2004;
5(2):
123 - 131.
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|
|
|
|
|
|
|
E Toscano, G Pacileo, G Limongelli, M Verrengia, O Di Mita, S Di Maio, M Salerno, E Del Giudice, B Caniello, R Calabro, et al.
Subclinical hypothyroidism and Down's syndrome; studies on myocardial structure and function
Arch. Dis. Child.,
November 1, 2003;
88(11):
1005 - 1008.
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[Full Text]
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|
|
|
|
|
|
|
D Pellerin, R Sharma, P Elliott, and C Veyrat
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November 1, 2003;
89(90003):
iii9 - 17.
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|
|
|
|
|
|
|
K. Skarvan, M. Filipovic, J. Wang, W. Brett, and M. Seeberger
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October 1, 2003;
91(4):
473 - 480.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
Z. Y. Fang, O. Najos-Valencia, R. Leano, and T. H. Marwick
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August 6, 2003;
42(3):
446 - 453.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Yuda, V. Khoury, and T. H. Marwick
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40(7):
1311 - 1319.
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[Full Text]
[PDF]
|
|
|
|
|
|
|
A. D. Waggoner
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July 1, 2002;
18(4):
218 - 230.
[Abstract]
[PDF]
|
|
|
|
|
|
|
G. Ansalone, P. Giannantoni, R. Ricci, P. Trambaiolo, F. Fedele, and M. Santini
Doppler myocardial imaging to evaluate the effectiveness of pacing sites in patients receiving biventricular pacing
J. Am. Coll. Cardiol.,
February 6, 2002;
39(3):
489 - 499.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. Isaaz
What are we actually measuring by Doppler tissue imaging?
J. Am. Coll. Cardiol.,
September 1, 2000;
36(3):
897 - 899.
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. Derumeaux, P. Mulder, V. Richard, A. Chagraoui, C. Nafeh, F. Bauer, J.-P. Henry, and C. Thuillez
Tissue Doppler Imaging Differentiates Physiological From Pathological Pressure-Overload Left Ventricular Hypertrophy in Rats
Circulation,
April 2, 2002;
105(13):
1602 - 1608.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
