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European Heart Journal 1996 17(6):940-950;
Copyright © 1996 by the European Society of Cardiology.
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© 1996 The European Society of Cardiology

Age-related transmural peak mean velocities and peak velocity gradients by Doppler myocardial imaging in normal subjects

P. Palka*,, A. Lange*, A. D. Fleming{dagger}, L. N. Fenn*, K. P. Bouki*, T. R. D. Shaw*, K. A. A. Fox{ddagger}, W. N. McDicken{dagger} and G. R. Sutherland*

*Department of Cardiology, Western General Hospital Crewe Road, Edinburgh EH4 2XU, U.K.
{dagger}Department of Medical Physics and Medical Engineering, Royal Infirmary, University of Edinburgh Edinburgh EH3 9 YW, U.K.
{ddagger}Cardiovascular Research Unit, University of Edinburgh Edinburgh EH8 9TB, U.K.

Received 29 August 1995; accepted 25 October 1995.

Correspondence: Dr P. Palka, Department of Cardiology, Western General Hospital. Crewe Road, Edinburgh EH4 2XU, Scotland, U.K.

Abstract

Doppler myocardial imaging is a new cardiac ultrasound technique based on the principles of colour Doppler imaging which can determine myocardial velocities by detecting the changes of phase-shift of the ultrasound signal returning directly from the myocardium. To determine the normal range of transmural velocities in healthy hearts a prospective study was carried out involving 42 normal subjects (age from 21 to 78, mean 47±16 years). Using M-mode Doppler myocardial imaging the peak values of the mean velocity and velocity gradient across the left ventricular posterior wall were measured during standardized phases of the cardiac cycle. Peak mean velocities had the following values during the cardiac cycle: isovolumic contraction –1·3±1·2cm. s–1, early ventricular ejection 4·2±1·2cm. s–1, late ventricular ejection 1·8±1·1cm. s–1, isovolumic relaxation –2·0±0·8cm .s–1, rapid ventricular filling –6·6±2·2cm. s–1, atrial contraction –2·8±1·8cm. s–1, atrial relaxation 1·2±1·1cm. s–1. Peak velocity gradients were: isovolumic contraction 1·3±1·9 s–1, early ventricular contraction 4·7±1·9s–1, late ventricular contraction 1·1 ±1·0 s–1, isovolumic relaxation –0·6±0·5 s–1, rapid ventricular filling 6·1±3·4 s–1, atrial contraction 2·6±1·7 s–1, atrial relaxation 0·0±0·3 s–1. Linear regression analysis showed that with the increase of age, peak velocity gradient decreases during rapid ventricular filling (r=0·83; P<0·0001) and increases during atrial contraction (r=0·86; P<0·0001) while peak mean velocity increases only during atrial contraction (r=0·80, P<0·0001). Thus, there was no correlation between increasing age and systolic peak mean velocity and peak velocity gradient but both diastolic filling phases rapid ventricular filling and atrial contraction demonstrated age-related changes.

In summary, this study has determined the age-related range of normal transmural myocardial velocities within the left ventricular posterior wall in healthy hearts during the cardiac cycle. We conclude that these measurements of peak mean velocities and peak velocity gradients, should form the baseline for subsequent Doppler myocardial imaging clinical studies on myocardial diseases processes.

Key Words: Ultrasound • colour Doppler • myocardium


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