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An evaluation of the use of new Doppler methods for detecting longitudinal function abnormalities in a pacing-induced heart failure modelBACKGROUND: Doppler tissue echocardiography and color M-mode Doppler flow propagation velocity have proven useful in evaluating cross-sections of patients with left ventricular (LV) dysfunction, but experience with serial changes is limited. Purpose and methods: We tested their use by evaluating the temporal changes of LV function in a pacing-induced congestive heart failure model. Rapid ventricular pacing was initiated and maintained in 20 dogs for 4 weeks. Echocardiography was performed at baseline and weekly during brief pacing cessation. RESULTS: With rapid pacing, LV volume significantly increased and ejection fraction (57%-28%), stroke volume (37-18 mL), and mitral annulus systolic velocity (16.1-6.6 cm/s) by Doppler tissue echocardiography significantly decreased, with ejection fraction and mitral annulus systolic velocity closely correlated (r = 0.706, P <.0001). In contrast to the mitral inflow velocities, mitral annulus early diastolic velocity decreased steadily (12.3-7.3 cm/s) resulting in a dramatic decrease in mitral annulus early/late (1.22-0.57) diastolic velocity with no tendency toward pseudonormalization. The color M-mode Doppler flow propagation velocity also showed significant steady decrease (57-24 cm/s) throughout the pacing period. Multiple regression analysis chose mitral annulus systolic velocity (r = 0.895, P <.0001) and propagation velocity (r = 0.782, P <.0001) for the most important factor predicting LV systolic and diastolic function, respectively. CONCLUSIONS: Doppler tissue echocardiography and color M-mode Doppler flow could evaluate the serial deterioration in LV dysfunction throughout the pacing period. These were more useful in quantifying progressive LV dysfunction than conventional ehocardiographic techniques, and were probably relatively independent of preload. These techniques could be suitable for longitudinal evaluation in addition to the cross-sectional study.
Document ID
Document Type
Reprint (Version printed in journal)
Tabata, Tomotsugu
(The Cleveland Clinic Foundation OH 44195, United States)
Cardon, Lisa A.
Armstrong, Guy P.
Fukamach, Kiyotaka
Takagaki, Masami
Ochiai, Yoshie
McCarthy, Patrick M.
Thomas, James D.
Date Acquired
August 21, 2013
Publication Date
May 1, 2003
Publication Information
Publication: Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography
Volume: 16
Issue: 5
ISSN: 0894-7317
Subject Category
Life Sciences (General)
Distribution Limits
Evaluation Studies
NASA Discipline Cardiopulmonary
Non-NASA Center

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