Document Detail


Anatomical M-mode: A novel technique for the quantitative evaluation of regional wall motion analysis during dobutamine echocardiography.
MedLine Citation:
PMID:  11219596     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Recognition of abnormal wall motion during dobutamine echocardiography requires an expert observer. Anatomical M-mode echocardiography may offer a novel quantitative approach to interpretation, amenable to less expert readers. We studied the application of this new modality to 124 patients (80 with known coronary anatomy and 44 patients at low probability of coronary disease) who underwent dobutamine echocardiography, using a standard protocol. Wall motion was interpreted by an experienced reader, using digitally stored 2-dimensional echocardiographic images at rest and peak stress. Percentage of systolic thickening was measured offline using anatomical M-mode echocardiography in the basal and mid segments at rest and peak dose, and compared with wall motion scores and coronary angiography. Of 729 segments, wall motion was identified as normal in 449, ischemic or viable in 171 and showed resting WM abnormalities only in 109 segments. After exclusion of the apex, anatomical M-mode measurements were feasible in 729 of 960 possible basal- and mid-zone segments (76%). Measurement of systolic thickening at peak dose was reproducible within (r2 = 0.83) and between observers (r2 = 0.93). Systolic thickening was significantly greater in segments with normal wall motion (37 +/- 2%) compared with ischemic or viable segments (30 +/- 2%, p < 0.001), and scar segments (23 +/- 3%, p < 0.001). There was an increment of thickening from rest to stress in normal and viable segments, no change in scar, and a decrement in ischemic segments. Significant coronary artery disease (defined by stenoses >70% diameter) was present in 59 patients. Systolic thickening showed significant variation between segments interpreted by wall motion scoring and angiography as true and false positive and true and false negative (p < 0.05). Measurement of systolic thickening using anatomical M-mode echocardiography offers an objective method to quantify systolic thickening at dobutamine echocardiography but has limited clinical feasibility.
Authors:
J Chan; S Wahi; P Cain; T H Marwick
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Controlled Clinical Trial; Journal Article    
Journal Detail:
Title:  International journal of cardiac imaging     Volume:  16     ISSN:  0167-9899     ISO Abbreviation:  Int J Card Imaging     Publication Date:  2000 Aug 
Date Detail:
Created Date:  2001-02-21     Completed Date:  2001-04-26     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8600426     Medline TA:  Int J Card Imaging     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  247-55     Citation Subset:  IM    
Affiliation:
University of Queensland, Brisbane, Australia.
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MeSH Terms
Descriptor/Qualifier:
Aged
Cardiotonic Agents / diagnostic use*
Coronary Angiography
Coronary Disease / radiography,  ultrasonography*
Dobutamine / diagnostic use*
Echocardiography / methods*
Evaluation Studies as Topic
Humans
Male
Middle Aged
Myocardial Contraction / drug effects,  physiology*
Observer Variation
Reference Values
Sensitivity and Specificity
Severity of Illness Index
Chemical
Reg. No./Substance:
0/Cardiotonic Agents; 34368-04-2/Dobutamine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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