Document Detail


Correlation of myocardial Doppler velocity response to exercise with independent evidence of myocardial ischemia by dual-isotope single-photon emission computed tomography.
MedLine Citation:
PMID:  11078263     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Myocardial Doppler velocity (MDV) imaging may provide an objective correlate of ischemia, thereby reducing the expertise needed for interpreting stress echocardiography and improving its reproducibility. This study sought to independently validate the results of exercise MDV imaging with single-photon emission computed tomography (SPECT) perfusion imaging in 116 patients (age 60+/-12 years, 28 women) referred for exercise SPECT for diagnostic or prognostic assessment of coronary artery disease. Two-dimensional echocardiography was performed with simultaneous color MDV data acquisition before and after exercise treadmill testing. MDV data were processed off-line to display myocardial velocity profiles in each segment at rest and peak exercise. SPECT was analyzed using a 16-segment model and segments were classified as normal or showing resting or stress defects. Resting defects within segments showing normal function were attributed to attenuation. Color MDV data were compared with SPECT results, and a multivariate analysis (including exercise and SPECT results) was performed to identify the determinants of the exercise MDV response. Patients exercised maximally (peak rate-pressure product 27.6+/-6.1x10(3), and SPECT was abnormal in 33 patients. Of the 1,333 left ventricular segments evaluable by SPECT and MDV, 1,217 segments were classified as normal, 43 showed a stress defect, and 73 a rest defect. Segmental comparison of thallium findings and MDV showed that segments with a rest defect had a lower velocity at rest and stress than normal segments (p<0.001). Segments with a stress defect had a marked reduction in peak exercise velocity and less increment in velocity than normal segments. Heart rate, functional capacity, and presence of abnormally perfused segments were independent predictors of myocardial velocity at peak exercise. Thus, color MDV correlates with independent evidence of ischemia, although it is also influenced by exercise capacity and left ventricular function. This technique may permit a feasible approach to quantitation of exercise echocardiography.
Authors:
A Pasquet; G Armstrong; C Rimmerman; T H Marwick
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Validation Studies    
Journal Detail:
Title:  The American journal of cardiology     Volume:  85     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2000 Mar 
Date Detail:
Created Date:  2000-12-01     Completed Date:  2000-12-01     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  536-42     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiology, Cleveland Clinic Foundation, Ohio, USA.
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MeSH Terms
Descriptor/Qualifier:
Blood Flow Velocity
Coronary Circulation
Echocardiography, Doppler, Color*
Exercise Test
Female
Humans
Linear Models
Male
Middle Aged
Myocardial Ischemia / physiopathology,  radionuclide imaging*,  ultrasonography*
Radiopharmaceuticals / diagnostic use
Reproducibility of Results
Technetium Tc 99m Sestamibi / diagnostic use
Thallium Radioisotopes / diagnostic use
Tomography, Emission-Computed, Single-Photon*
Chemical
Reg. No./Substance:
0/Radiopharmaceuticals; 0/Thallium Radioisotopes; 109581-73-9/Technetium Tc 99m Sestamibi

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


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