Analysis of Postsystolic Myocardial Thickening Work in Selective Myocardial Layers During Progressive Myocardial Ischemia

Jianwen Wang, Stig Urheim, Josef Korinek, Theodore P. Abraham, Eileen M. McMahon, Marek Belohlavek

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Abstract

Background: Myocardial function is transmurally heterogeneous. Postsystolic work may functionally reflect ischemic but viable myocardium. We calculated systolic and postsystolic regional myocardial work index (RMWi) in subendocardial and subepicardial layers of myocardium supplied by a slowly occluding coronary artery. Methods: Progressive stenosis of the left anterior descending coronary artery lasting 11 ± 5 days (end point) was induced in 10 dogs, and pressure-strain loops were obtained from subendocardial and subepicardial layers of apical and middle anterior segments by intracardiac ultrasound. Results: At baseline, the RMWi was significantly higher (P < .05) in the subendocardial layer. At the end point, there was no significant change in the RMWi in ischemic myocardium; however, the postsystolic RMWi was higher (P < .05) in the subendocardial layer and accompanied a decrease in subendocardial myocardial blood flow, although viability was largely maintained. Conclusion: A significant subendocardial postsystolic RMWi at rest suggests an impending ischemic injury in coronary artery disease when segmental function is still preserved.

Original languageEnglish (US)
Pages (from-to)1102-1111
Number of pages10
JournalJournal of the American Society of Echocardiography
Volume19
Issue number9
DOIs
StatePublished - Sep 1 2006

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ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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