Document Detail

Detection of coronary artery disease using delayed strain imaging at 5 min after the termination of exercise stress: head to head comparison with conventional treadmill stress echocardiography.
MedLine Citation:
PMID:  20122547     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Prolongation of the time to peak strain (TPS) is a sensitive marker of myocardial ischemia. The purpose of this study was to evaluate whether delayed strain imaging obtained at 5 min after the termination of exercise stress can detect patients with significant coronary artery disease (CAD). METHODS: A total of 45 patients who underwent treadmill stress echocardiography and coronary angiography were studied. Patients with abnormal wall motion at rest were excluded. Digital echocardiographic images were recorded at baseline and immediately after the termination of treadmill stress. Exercise-induced wall motion abnormality was considered as a marker of myocardial ischemia. Tissue velocity images were also recorded at baseline and 5 min after the termination of treadmill stress, and TPS was measured. TPS ratio was calculated as the ratio between TPS at delayed post-exercise and TPS at baseline. RESULTS: Coronary angiography revealed that 30 of the 45 patients had significant CAD > or =50% diameter stenosis. The receiver operating characteristics curve demonstrated that cut-off value of TPS ratio 1.10 provides best diagnostic accuracy for vessel-based detection of significant CAD. The sensitivity, specificity, and diagnostic accuracy of the conventional exercise stress echocardiography for detecting patients with CAD were 87%, 80%, and 84%, respectively. The sensitivity, specificity, and accuracy of delayed strain imaging for identifying patients with CAD were 93%, 73%, and 87%, respectively. CONCLUSION: Delayed strain imaging obtained at 5 min after the termination of exercise stress can accurately detect patients with significant CAD.
Tsutomu Takagi; Atsushi Takagi; Junichi Yoshikawa
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2009-09-20
Journal Detail:
Title:  Journal of cardiology     Volume:  55     ISSN:  0914-5087     ISO Abbreviation:  J Cardiol     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-02-03     Completed Date:  2010-08-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8804703     Medline TA:  J Cardiol     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  41-8     Citation Subset:  IM    
Copyright Information:
2009 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.
Takagi Cardiology Clinic, Mibu Kayogosho-cho 3-3, Nakagyo-ku, Kyoto 604-8811, Japan.
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MeSH Terms
Aged, 80 and over
Coronary Angiography
Coronary Artery Disease / diagnosis*
Echocardiography, Stress / methods*
Exercise Test*
ROC Curve
Sensitivity and Specificity
Time Factors

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