Role of Quantitative Wall Motion Analysis in Patients with Acute Chest Pain at Emergency Department

다국어 초록 (Multilingual Abstract)

Background: Evaluation of acute chest pain in emergency department (ED), using limited resource and time, is still very difficultdespite recent development of many diagnostic tools. In this study, we tried to determine the applicability of new semi-automatedcardiac function analysis tool, velocity vector imaging (VVI), in the evaluation of the patients with acute chest pain in ED.
Methods: We prospectively enrolled 48 patients, who visited ED with acute chest pain, and store images to analyze VVI fromJuly 2005 to July 2007.
Results: In 677 of 768 segments (88%), the analysis by VVI was feasible among 48 patients. Peak systolic radial velocity (Vpeak)and strain significantly decreased according to visual regional wall motion abnormality (Vpeak, 3.50 ± 1.34 cm/s for normal vs.
3.46 ± 1.52 cm/s for hypokinesia, 2.51 ± 1.26 for akinesia, p < 0.01; peak systolic radial strain -31.74 ± 9.15% fornormal,-24.33 ± 6.28% for hypokinesia, -20.30 ± 7.78% for akinesia, p < 0.01). However, the velocity vectors at the time of mitral valveopening (MVO) were directed outward in the visually normal myocardium, inward velocity vectors were revealed in the visuallyakinetic area (VMVO, -0.85 ± 1.65 cm/s for normal vs. 0.10 ± 1.46 cm/s for akinesia, p < 0.001). At coronary angiography, VMVOclearly increased in the ischemic area (VMVO, -0.88+1.56 cm/s for normal vs. 0.70 + 2.04 cm/s for ischemic area, p < 0.01).
Conclusion: Regional wall motion assessment using VVI showed could be used to detect significant ischemia in the patientwith acute chest pain at ED.

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