| Objectives: To observe the changes on heart structure and function with echocardiogram and pulsed wave Doppler tissue imaging ( PW-DTI) in acute myocardial infarction (AMI) patients. To approach the changes of asynchrony of inter and intro ventricular after AMI. To evaluation the clinical value of PW-DTI.Methods: control subjects 48 , average age 57.81 ?.59. AMI patients 102, average age 60.8710.7, onset of AMI about 1 week. The AMI group was divided into anterior AMI group (anterior group) and inferior AMI group (inferior group) according to ECG leads of Q appearance. Standard echocardiography, flow velocities and PW-DTI were performed. EF was used as systolic function parameter of left ventricular; systolic velocity (Vs) was used as systolic velocity parameter of DTI; early diastolic velocity (Ve) and late diastolic velocity (Va) was used as diastolic velocity parameter of DTI; the tune from Q to the onset of systolic wave (Q-so), the time from Q to peak of systolic wave (Q-sp) and systolic wave time (Ds) was used as systolic time parameter of DTI; the time from Q to the onset of diastolic wave (Q-eo) , the time from Q to peak of diastolic wave (Q-ep) and early diastolic wave time (De) was used as diastolic time parameter of DTI; We used AQ-so, AQ-sp, AQ-eo and AQ-ep as the different between tricuspid and mitral annular motion (tricuspid -mitral). We compared the parameters between control group and AMI group or AMI subgroups. We also followed up some AMI patients on 1 month, 3 month andl year-Results:1. After one week of AMI onset, LVDD and LAD in AMI group is larger than that in control group (p<0.01). EF in AMI group is lower than that in control group (p<0.01). The heart remodeling and decreased systolic function is indicated.2. In AMI group, the Dopple flow parameters VE, VA, E/A and IVRT increase comparedwith control group, but no significant. DTI parameters in AMI group, Vs, Ve is lower significantly (p<0.01); Q-so, ivrt prolonged significantly (p<0.0l); Ds,De decreased significantly (p<0.01); e/a decreased significantly (p<0.01) and E/e increased significantly compared with control group. It indicated that ventricular motion and diastolic function decreased after AMI. PW-DTI is superior in showing the changes of myocardial motion compared with echocardiography and Dopple flow imagine.3. In anterior AMI group, Vs at three points of mitral annular decreased significantly compared with control group (p<0.01, p<0.05, p<0.01) and Ve is also lower than control group (p<0.01). In inferior AMI group, only Vs at posterior annular is lower than control group (p<0.01) but Ve at three points of mitral annular decreased significantly (p<0.01, p<0.05, p<0.01). it suggested that after anterior AMI, annular contraction decreased more intensively compared with inferior AMI. But early diastolic motion decrease is similar in both two subgroups,4. PW-DTI parameters of myocardial motion time is no different between AMI and control group. AQ-so is different significantly between anterior and inferior AMI groups (p<0.01). AQ-so in anterior AMI group is negative while it is positive in inferior AMI and control groups, indicating the systolic motion in mitral annular is delayed comparing with that in tricuspid annular. AQ-eo in anterior AMI group is larger than control group (p<0.05),suggesting the change of inter-ventricular asynchrony has taken place.5. In control group, Q-so at three points of mitral annular is no different, hi anterior AMIgroup, Q-so between lateral and posterior is different significantly (p<0.05), inn inferior AMI group, Q-so among three points also different significantly, suggesting the change of intro-ventricular systolic asynchrony has taken place. In anterior AMI group, ivrt at three points increased comparing with control group (p<0.01), in inferior AMI group, ivrt at inner and posterior increased comparing with control group (p<0.01, p<0.06), suggesting the change of intro-ventricular diastolic asynchrony has taken place, and the effect of anterior is more extensive.6. There are...
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