Biomedical subjects

Y Mishiro

Publications and source records attributed to Y Mishiro.

At least 19 recordsLinked to original sources

PubMed2006

Surgical management of only hearing ears with positive indications.

Positive surgical indications for an only hearing ear were evaluated in order to improve patients' quality of life. Fifteen cases of surgery involving an only hearing ear over the past eight years were retrospectively reviewed. Of eight perforated chronic otitis media cases, seven underwent type one tympanoplasty and one underwent simple underlay myringoplasty regardless of otorrhoea at the time of surgery. Of six cholesteatoma cases, two received the canal wall up method and four received the canal wall down method. Ossiculoplasty was carefully performed in six cases. Hearing was improved in seven cases, whereas it remained unchanged in seven cases and deteriorated in one case. Of nine patients, two did not need a hearing aid after surgery. Five patients with severe combined hearing loss (>90 dB) were able to communicate with a hearing aid, alleviating their anxiety regarding hearing loss. Only hearing ears with chronic otitis media and cholesteatoma can be successfully treated by tympanoplasty with or without ossiculoplasty.

Adolescent↗

PubMed2001

Younger patients have a higher rate of recovery of taste function after middle ear surgery.

BACKGROUND: Although the chorda tympani nerve (CTN) is frequently damaged during tympanoplasty, little attention has been given to the patients' symptoms and taste function. OBJECTIVE: To investigate patients' symptoms and the functional recovery of taste after surgery using electrogustometry (EGM). DESIGN: Prospective study. PATIENTS: Analysis of 163 ears of 156 patients who underwent middle ear surgery from April 1997 through December 1999. There were 18 ears with noninflammatory diseases, 80 with chronic otitis media, and 65 with cholesteatoma. The patients' taste functions were examined 2 days before surgery and 2 weeks and 6 months after surgery. MAIN OUTCOME MEASURES: The taste disturbance before and after middle ear surgery and the relationship between age and the recovery rate of CTN function. RESULTS: Two weeks after surgery, the mean EGM threshold was elevated in all groups regardless of preservation or section of the CTN. Numbness in the tongue and taste disturbance were more frequently found in patients with preservation of CTN than in those with section of the CTN (P =.008 and P =.001, respectively). In patients with preservation of the CTN, 6 months after surgery, the recovery rate of EGM threshold was 83% in those aged 20 years or younger (P =.008 compared with the 2 older groups), 53% in the those aged 21 to 40 years, and 44% in those aged 41 to 60 years. CONCLUSION: Age is an important factor for recovery of taste function after middle ear surgery, which is useful information when explaining complications to patients.

Adolescent↗

PubMed2001

Tympanoplasty with and without mastoidectomy for non-cholesteatomatous chronic otitis media.

OBJECTIVES: Cases of non-cholesteatomatous chronic otits media (COM) were reviewed to determine whether mastoidectomy is helpful when combined with tympanoplasty for these conditions. STUDY DESIGN: A retrospective analysis of 251 ears with non-cholesteatomatous COM operated on by one surgeon (Y.M.) in an 11-year period was conducted. METHODS: Patients in group A (n = 147) were treated by tympanoplasty with mastoidectomy. Patients in group B (n = 104) were operated on without mastoidectomy. RESULTS: Graft success rates were 90.5% in group A and 93.3% in group B. There was no statistically significant difference. Graft success rates of discharging ears were 90.0% in group A and 85.7% in group B. Graft success rates of dry ears were 90.7% in group A and 94.4% in group B. There was no statistically significant difference between discharging ears and dry ears. The rates of the postoperative air-bone gap within 20dB were 81.6% in group A and 90.4% in group B, without a statistically significant difference. CONCLUSIONS: Mastoidectomy is not helpful in tympanoplasty for non-cholesteatomatous COM, even if the ear is discharging.

Bone Conduction↗

PubMed2001

Effects of exposing the opened endolymphatic sac to large doses of steroids to treat intractable Meniere's disease.

To enhance the effect of treatment for intractable Meniere's disease, we exposed the opened endolymphatic sac to high concentrations of steroids. This technique--endolymphatic sac drainage and steroid instillation surgery--involves the application of a mass of prednisolone followed by absorbable gelatin sponges soaked in a high concentration of dexamethasone into a sac lumen opened and expanded with a bundle of absorbable gelatin film. These sponges are also placed around the sac and coated with biochemical adhesive so that the medicine is slowly delivered into the sac over a prolonged period of time by means of a natural sustained-release vehicle. The short-term results (6 to 14 months) in 12 patients with Meniere's disease, including those in stage IV, treated by the above techniques showed that definitive spells were completely controlled in all cases. Hearing was improved, and annoyance due to tinnitus was decreased in all cases except one.

Adult↗

PubMed2001

[Endolymphatic sac drainage and steroid-instillation surgery (EDSS) for intractable Meniere's disease].

Endolymphatic sac surgery is one of the most widely accepted techniques used to treat intractable Meniere's disease. To improve this surgery, we developed the following techniques: A simple mastoidectomy was used to expose the endolymphatic sac between the sigmoid sinus and inferior margin of the posterior semicircular canal. The sac was opened and filled with a mass of prednisolone. A bundle of absorbable gelatin films was then inserted into the sac lumen to expand it, followed by gelatin sponges dipped in a high concentration of dexamethasone. Long-term results (17-32 months) in 20 patients with intractable Meniere's disease treated with endolymphatic sac drainage and steroid-insertion surgery (EDSS) showed that definitive spells were completely controlled in 15 of 20 cases (75%); all reports of vertigo decreased; hearing improved in 12 of 20 cases (60%); and annoyance due to tinnitus decreased in 15 of 20 cases (75%). Steroids directly instilled into the endolymphatic cavity may thus be more effective with the diseased inner ear organs than those applied via any other route. Draining of endolymphatic fluid at the sac into the mastoid cavity also contributed to these satisfactory EDSS results.

Adult↗

PubMed2000

Detection of left ventricular regional relaxation abnormalities and asynchrony in patients with hypertrophic cardiomyopathy with the use of tissue Doppler imaging.

BACKGROUND: It is well known that the distribution and magnitude of left ventricular (LV) hypertrophy are not uniform in patients with hypertrophic cardiomyopathy (HCM), which results in regional heterogeneity of LV early diastolic function. The advent of tissue Doppler imaging (TDI) has allowed the noninvasive evaluation of regional LV wall motion velocities. The aim of this study was to evaluate regional LV relaxation abnormalities and asynchrony noninvasively in patients with HCM by using pulsed and color-coded TDI. METHODS AND RESULTS: We studied 20 patients with asymmetric septal hypertrophy (HCM group) and 18 age-matched normal patients (control group). The peak early diastolic motion velocity (Ew) and time from the aortic component of the second heart sound to the peak of the Ew (II(A)-Ew) were measured by pulsed TDI. The myocardial velocity gradient during early diastole (MVG-Ew) also was measured by color-coded TDI. Mean values for these parameters were determined on the basis of measurements made at 2 sites of the ventricular septum or posterior wall at the levels of chordae tendineae and papillary muscles. The mean Ew and mean MVG-Ew for the ventricular septum and posterior wall were significantly lower, and mean II(A)-Ew was significantly prolonged in the HCM group compared with the control group. This difference was most pronounced in the hypertrophied ventricular septum of the HCM group. The standard deviations of II(A)-Ew for the ventricular septum and posterior wall were significantly greater in the HCM group than in the control group. The time constant of LV pressure decay during isovolumic diastole (tau) correlated inversely with Ew and MVG-Ew and correlated directly with II(A)-Ew. Furthermore, tau correlated directly with the standard deviation of the II(A)-Ew. CONCLUSIONS: LV early diastolic function in patients with HCM may be mediated by an augmentation of regional LV relaxation abnormalities and asynchrony.

Adult↗

PubMed2000

Postoperative results for cholesteatoma in children.

OBJECTIVES: to review the postoperative results for cholesteatoma in children. MATERIALS: 32 ears with acquired cholesteatoma in children operated on by a single surgeon between 1987 and 1995 and followed up more than 2 years. The mean follow-up period was 5.4 years. RESULTS: a one-stage operation was performed in seven ears (21.9%) and preplanned stage operation in 25 ears (78.1%). In the first operation, closed tympanoplasty was performed in 31 ears (96.9%) and open tymapanoplasty in one ear (3.1%). During the second stage operation, residual cholesteatoma was found in 16 ears (64.0%). Recurrent cholesteatoma was detected in 19.4% of ears treated with closed tympanoplasty. The mean postoperative air conduction hearing level was within 20 dB in 12.5%, 30 dB in 40.6% and 40 dB in 78.1%. The hearing results of type III tympanoplasty was better than those of type IV tympanoplasty. CONCLUSIONS: preplanned stage tympanoplasty is safer because of the high risk of recurrent and residual cholesteatoma. Surgical methods should be selected flexibly in individual cases depending upon cavity size, eustachian tube function and hearing level. Cholesteatoma in children should be operated on while stapes is present.

Adolescent↗

PubMed2000

Bilateral same day surgery for bilateral perforated chronic otitis media.

OBJECTIVE: Bilateral same day surgery has been performed rarely because of the risk of postoperative sensorineural hearing loss following conventional myringoplasty or tympanoplasty (CMT). Simple underlay myringoplasty (SUM) through the ear canal has been developed by Yuasa R, Saijo S, Tomioka Y, et al. Office closure of eardrum perforation with fibrin glue (in Japanese), Otolaryngol Head Neck Surg (Tokyo) 1989;61:1117-1122, which has little risk of sensorineural hearing loss. We tried bilateral same day surgery using this technique and evaluated its outcome. METHODS: Of 86 cases with bilateral perforated chronic otitis media that we treated between 1995-1997, 25 cases underwent bilateral same day surgery. Bilateral SUMs was performed on seven patients, SUM and CMT on 16 patients, and bilateral CMTs on two patients. RESULTS: Closure of perforation was successful in 18 patients (72%) on both sides and in seven patients (28%) on one side. Postoperative air-bone gap of less than 20 dB was achieved in 15 cases (60%) on both sides and in 23 cases (92%) on one side. CONCLUSION: Bilateral same day surgery for bilateral perforated chronic otitis media is possible if the operative indications are considered.

Adolescent↗

PubMed2000

Long-term observation on hearing change in patients with chronic otitis media.

OBJECTIVE: Very few reports are available in the literature to clarify the natural long course of hearing change in an individual patient with chronic otitis media (COM). We reviewed hearing change in patients suffering from perforated COM without an operation. METHODS: Eighty-seven ears of 70 patients had COM with tympanic perforation and were observed without an operation. The mean follow-up period was 10.7 years (5-22 years) and the mean age at the first examination was 51.3 years. To minimize the effect of aging, 23 patients with normal ear drums on the other side were further analyzed. RESULTS: All 87 ears tended to show deterioration of hearing gradually under long observation. In 23 patients, hearing deterioration was 0.13 dB/year in the control side and 0.61 dB/year in the COM side (P < 0.02). Although elevation of bone conduction hearing level tended to be larger at high frequencies than at low and middle frequencies, there was no significant difference between COM and normal ears. CONCLUSIONS: Air conduction hearing levels deteriorated with the passage of time and surgery is recommended at the early stage of COM to prevent progress of hearing loss.

Adult↗

PubMed2000

Use of angiotensin II stress pulsed tissue Doppler imaging to evaluate regional left ventricular contractility in patients with hypertrophic cardiomyopathy.

There is controversy concerning whether contract-ility in the nonhypertrophied region of the left ventricular (LV) wall is impaired or normal in patients with hypertrophic cardiomyopathy (HCM). Global LV systolic function decreases with increases in afterload in this disease. This study was performed to identify abnormalities in regional LV contractility along the long and short axes in the setting of HCM with the use of angiotensin II (AT-II) stress pulsed tissue Doppler imaging (PTDI). Angiotensin II was administered intravenously to patients with asymmetric septal hypertrophy (HCM group, n = 21) and age-matched normal volunteers (N group, n = 12). We then measured the percent LV fractional shortening (%FS) and end-systolic circumferential LV wall stress by M-mode echocardiography, LV ejection fraction (LVEF) by 2-dimensional echocardiography, and time-velocity integral (TVI) of LV outflow velocity by pulsed Doppler echocardiography. The peak first and second systolic LV wall motion velocities along the long (L-Sw(1) and L-Sw(2)) and short (S-Sw(1) and S-Sw(2)) axes were measured in the LV posterior wall and ventricular septum with the use of PTDI. The end-systolic circumferential LV wall stress at baseline was significantly lower in the HCM group. The L-Sw(1) and L-Sw(2) for the posterior wall were significantly lower in the HCM group, but the S-Sw(1) and S-Sw(2) for the posterior wall and ventricular septum were similar in the two groups. The %FS, LVEF, TVI, and systolic PTDI variables along both axes for the posterior wall decreased significantly, and end-systolic circumferential LV wall stress increased significantly at AT-II doses of 0.005 or 0.010 microg/kg per minute in the HCM group. No significant changes were found in either group in the systolic PTDI variables (except for L-Sw(1)) for the ventricular septum with AT-II infusion. Contractility along the long and short axes of the nonhypertrophied LV wall is easily impaired with increases in afterload in patients with HCM, resulting in a decrease in global LV systolic function. We found AT-II stress PTDI to be a safe and useful technique for evaluating the regional LV systolic function in this disease.

Analysis of Variance↗

PubMed2000

[Vestibular symptoms and ENG findings during periods of convalescence after endolymphatic sac drainage and steroid-instillation surgery (EDSS)].

Understanding the appearance of vestibular symptoms during periods of convalescence after surgery for the treatment of Meniere's disease is important for determining when a patient can return to work as well as the long-term results of the operation. We have treated 20 cases of intractable Meniere's disease with endolymphatic sac drainage & steroid-instillation surgery (EDSS) [Kitahara T, et al., Ann Otol Rhlnol Laryngol in press, 2000] and observed the subjective symptoms and objective vestibular findings using electronystagmogram (ENG) during the subsequent period of convalescence. The average postoperative durations of subjective static and evoked vestibular symptoms were 1.7 and 6.7 days, respectively. Those of spontaneous, positional and positioning nystagmus observed using ENG were 1.2, 2.0 and 7.9 days, respectively. In cases with a long history of Meniere's disease, postoperative static vestibular sensation and positional nystagmus lasted significantly longer than in cases with short histories. In cases with poorly developed temporal bony pneumatization in the area behind the posterior semicircular canal, postoperative evoked vestibular sensations and positioning nystagmus lasted significantly longer than in cases with well developed temporal bony pneumatization. Vestibular symptoms resulting from direct invasion during EDSS were considered to be slighter than those resulting from vestibular neurectomy or gentamicin treatment and almost the same as those resulting from endolymphatic sac surgery.

Adult↗

PubMed2000

[Management of the acoustic tumor in an only/better hearing ear].

Because profound bilateral hearing impairment is a catastrophic event, the management and care of an individual with an 8th nerve lesion in an only/better hearing ear remains a significant challenge for both patient and physician. Current options regarding the treatment of the acoustic tumor in an only/better hearing ear include: observation, attempted hearing preservation surgery and stereotactically guided radiation therapy. In this article, we present 3 cases of acoustic tumor within the internal auditory canal in an only/better hearing ear diagnosed by gadolinium-enhanced MRI and discuss the recommendations, especially observation, available in the care of these cases. In one patient, hearing disturbance caused by the tumor in a better hearing ear made the patient quite depressive and desperate. One of the most important consideration is for the physician to provide the patient with adequate informed consent regarding the possibility of profound bilateral hearing loss caused by either the natural growth or surgical removal of the tumor in the future, and alternative methods of communication with others such as: hearing aid and lip reading, cochlear implant and brainstem implant.

Aged↗

PubMed1999

Cholesteatoma otitis media with intact ossicular chain.

Thirty-one cases of cholesteatoma with intact ossicular chain were reviewed to examine the extension of cholesteatoma, operation procedures, pre- and postoperative hearing levels, and postoperative condition of the ear drum. They were operated on at Departments of Hyogo College of Medicine and Osaka University Medical School from 1989-1996, which were 20.4% of all of the primary cholesteatoma cases (n = 152). Twelve cases located at attic were operated by atticotomy or canal wall up and scutumplasty, 17 cases located at attic/antrum were operated by canal wall down and reconstruction, and two cases located around stapes were operated through the ear canal. Preoperative hearing level was mild (34.2 +/- 18.4 dB) and postoperative one was slightly improved (28.7 +/- 11.2 dB). In ossicular reconstruction, modified Wullstein type III method showed better hearing gain than Wullstein type I method. Postoperative attic retraction and/or pocket occurred in 15 cases (48.4%), but no recurrent cholesteatoma was found during the present follow-up period. These findings suggested that cholesteatoma with intact ossicular chain showed good postoperative hearing results, but postoperative retraction of the ear drum should be followed up for a long time.

Adolescent↗

PubMed1999

Effect of aging on diastolic left ventricular myocardial velocities measured by pulsed tissue Doppler imaging in healthy subjects.

We evaluated the effect of aging on diastolic left ventricular (LV) wall motion velocity in 80 healthy persons with the use of pulsed tissue Doppler imaging. The wall motion velocity patterns were recorded at the middle regions of the LV posterior wall and ventricular septum in the parasternal (along the short axis) and apical (along the long axis) LV long-axis views. In the posterior wall, the peak early diastolic wall motion velocities (Ews) along both axes correlated inversely with age (long axis: r = -0.61, P <. 0001; short axis: r = -0.55, P <.0001), and the peak atrial systolic wall motion velocities(Aws) along both axes correlated directly with age (long axis: r = 0.59, P <.0001; short axis: r = 0.65, P <.0001). In the ventricular septum, the Ew along the long axis correlated inversely with age (r = -0.51, P <.0001), and the Aws along both axes correlated directly with age (long axis: r = 0.57, P <.0001; short axis: r = 0.53, P <.0001). The Ews along both axes at the posterior wall correlated directly with the peak early diastolic transmitral flow velocity. The Aws along both axes at the ventricular septum and posterior wall correlated directly with the peak atrial systolic transmitral flow velocity. The times from the second heart sound to the peak of the early diastolic waves of the ventricular septum and posterior wall along both axes significantly increased with age. The times from the aortic component of the second heart sound to the peak of the early diastolic motion velocities along both axes were significantly longer at the ventricular septum than at the posterior wall. Pulsed tissue Doppler imaging may be useful for evaluating the effect of aging on diastolic LV function in healthy persons.

Aging↗

PubMed1999

Pulsed tissue Doppler imaging of left ventricular systolic and diastolic wall motion velocities to evaluate differences between long and short axes in healthy subjects.

Our objective was to evaluate in healthy subjects the left ventricular (LV) wall motion velocities along the long and short axes by means of pulsed tissue Doppler imaging (TDI) to clarify the differences in the LV systolic and diastolic function between both axes. Wall motion velocities were recorded at the mid-wall portion of the middle site of the LV posterior wall in the parasternal long-axis view, and at the subendocardial portion of the middle site of the LV posterior wall in the apical long-axis view by pulsed TDI in 35 healthy subjects (mean age 26 +/- 10 years, mean heart rate 72 +/- 7 bpm). In all subjects, the LV pressure curve, its first derivative (dP/dt), the LV wall motion velocity, the phonocardiogram, and the electrocardiogram were simultaneously recorded. The systolic wave of the LV posterior wall motion velocity exhibited 2 peaks: the first and second systolic waves (Swl and Sw2, respectively). The diastolic wave also exhibited 2 peaks, the early diastolic and atrial systolic waves. The Swl along the long axis was greater than either the Sw1 and Sw2 along the short axis or the Sw2 along the long axis. The peak Sw1 along the long axis coincided with the peak dP/dt and was slightly earlier than the peak Swl along the short axis. The onset of Sw1 along the long axis coincided with the onset of the first heart sound. The Sw2 along the short axis was greater than that along the long axis. The early diastolic wave along the short axis was greater than that along the long axis, whereas the atrial systolic wave along the long axis was greater than that along the short axis. Thus, in healthy subjects, shortening of the longitudinal fibers predominated over that of the circumferential fibers during early systole, whereas shortening of the circumferential fibers predominated over the longitudinal fibers during the ejection phase. During diastole, the circumferential fibers predominated in the LV wall expansion at early diastole, whereas the longitudinal fibers predominated at atrial systole. In conclusion, pulsed TDI provided information that is useful in understanding the characteristics of LV wall motion along the long and short axes.

Adult↗

PubMed1999

Effect of an acute increase in afterload on left ventricular regional wall motion velocity in healthy subjects.

We recorded left ventricular (LV) wall motion velocities before and after angiotensin II infusion by pulsed tissue Doppler imaging in 20 healthy subjects, and evaluated the responses of systolic and diastolic LV function along the long and short axes during an acute increase in afterload. Angiotensin II was administered intravenously to obtain a 30% increase in mean blood pressure. After angiotensin II infusion, LV end-systolic dimension and end-systolic circumferential wall stress increased significantly, and the percentage of LV fractional shortening decreased significantly. Peak first systolic LV wall motion velocity (Sw1 ) along the long axis decreased markedly compared with that along the short axis, and peak second systolic LV wall motion velocity (Sw2 ) along the short axis decreased significantly compared with that along the long axis. Early diastolic LV wall motion velocities along both the long and short axes decreased significantly, whereas atrial systolic LV wall motion velocity did not change. In conclusion, an acute increase in afterload caused a significant decrease in longitudinal fiber shortening during the isovolumic contraction phase (Sw1 along the long axis), circumferential fiber shortening during the ejection phase (Sw2 along the short axis), and LV relaxation during early diastole (early diastolic LV wall motion velocities along both axes) in healthy subjects. Pulsed tissue Doppler imaging may be useful for detecting the effect of various loading conditions on LV wall motion velocities along the long and short axes.

Adult↗

PubMed1999

Left ventricular systolic wall motion velocities along the long and short axes measured by pulsed tissue Doppler imaging in patients with atrial fibrillation.

Pulsed tissue Doppler imaging was performed to measure systolic left ventricular (LV) posterior wall motion velocity along the long and short axes and to evaluate the relationships between the systolic variables and the maximum first derivative (peak dP/dt) of the LV pressure curve and the 2 preceding R-R intervals in 39 patients with atrial fibrillation (AF). The study group consisted of 22 patients with AF only, 17 patients with dilated or ischemic cardiomyopathy and AF, and 25 healthy control subjects in sinus rhythm. The systolic component of the LV posterior wall motion velocity was divided into the first (Sw1) and second (Sw2 ) systolic waves. The peak Sw1 along the long axis was greater than either that along the short axis or the peak Sw2s along the long and short axes in the control and AF-only groups. The peak Sw1 along the long axis was lower in the AF-only group than in the control group, and those along the short and long axes were lower in the dilated AF group than in the other groups. The peak Sw1 almost coincided with the peak dP/dt. The peak Sw1 along the long axis correlated closely with the peak dP/dt, and the ratio of the preceding R-R interval to the interval before the preceding ("prepreceding") R-R interval in both AF groups, particularly in the dilated AF group, and the slopes of their relationships were steeper in the dilated AF group than in the AF-only group. The peak Sw2 along the short axis was greater than that along the long axis in the control and AF-only groups. The peak Sw2 along the long axis was lower in the AF-only group than in the control group, and those along the short and long axes were lower in the dilated AF group than in the other groups. The peak dP/dt was lower and the LV end-diastolic pressure was higher in the dilated AF group than in the other groups. In conclusion, peak Sw1 along the long axis is useful for the evaluation of isovolumic myocardial LV contractility, and the interval-force relation and the Frank-Starling mechanism are important factors of beat-to-beat variability in systolic LV function in patients with AF.

Atrial Fibrillation↗

PubMed1999

Evaluation of left ventricular contraction abnormalities in patients with dilated cardiomyopathy with the use of pulsed tissue Doppler imaging.

The left ventricular (LV) systolic wave, as recorded by pulsed tissue Doppler imaging, usually consists of 2 components (Sw(1) and Sw(2)). However, the clinical significance of these waves has not been studied in patients with dilated cardiomyopathy (DCM) and sinus rhythm. We studied 25 patients with DCM (DCM group) and 22 age-matched normal subjects (control group). The LV posterior wall motion velocities along the short and long axes were recorded by pulsed tissue Doppler imaging, and the peak velocities of the Sw(1) and Sw(2) and the times from the electrocardiographic Q wave to the peak Sw(1) and Sw(2) (Q-Sw(1) and Q-Sw(2), respectively) were determined. In all patients cardiac catheterization was performed immediately after the noninvasive examination, and the LV end-diastolic pressure and peak dP/dt were determined. The LV end-diastolic pressure and peak dP/dt were significantly greater and lower, respectively, in the DCM group. The peak Sw(1) along the long axis was significantly greater than Sw(1) and Sw(2) along the short axis and Sw(2) along the long axis in the control group. The peak Sw(1) and Sw(2) along the long and short axes were all significantly lower in the DCM group than in the control group. The Q-Sw(1) along the long axis was significantly shorter than that along the short axis, whereas no significant difference was seen in the Q-Sw(2) in either axis in any patient. The Q-Sw(1) and Q-Sw(2) along both axes were significantly longer in the DCM group than in the control group. All systolic pulsed tissue Doppler imaging variables, particularly the peak Sw(1) along the long axis, correlated well with the peak dP/dt in all patients. LV contractility along both the short and long axes is commonly impaired in patients with DCM. In particular, peak Sw(1) along the long axis is a useful parameter for evaluating LV myocardial contractility during isovolumic contraction.

Blood Flow Velocity↗