Document Detail


Doppler derived coronary flow reserve during dobutamine stress echocardiography further improves detection of myocardial ischemia.
MedLine Citation:
PMID:  15996524     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The coronary flow velocity (CFV) has been used to estimate coronary flow reserve (CFR) during dobutamine stress echocardiography (DSE). However, the relationship of the CFR to myocardial wall thickening (WT) has not been investigated. OBJECTIVES: The aims of this study were: (1) to assess the feasibility of obtaining systolic and diastolic CFV and thus CFR during DSE and (2) to assess the relation between CFR and stress induced WT. METHODS: Distal left anterior descending CFV was recorded by transthoracic Doppler echocardiography during DSE. Systolic and diastolic velocities were measured at rest, low and peak dobutamine doses, simultaneously, WT of distal anteroseptal segment was assessed by 2D-guided M-mode. The CFV and CFR of patients with normal WT defined as thickening of >50% (group 1) at peak stress were compared to that of patients with abnormal WT (group 2). RESULTS: A total of 67 patients, 34 females and 33 males (mean age of 66.5+/-14.5 years) were studied. The feasibility of assessing the CFR was 97% from peak diastolic velocity, 91% from diastolic time velocity integral, 91% from peak systolic velocity, and 90% from systolic time velocity integral. Contrast agent was used in 6 patients (7%) to obtain the CFV. Twenty-five of 67 patients demonstrated abnormal wall thickening. The percentage of WT was 30.9+/-15.7% in group 2 compared to 80.8+/-24.3% in group 1 (p<0.0001). The 25 patients in group 2, who developed abnormal WT, demonstrated significantly lower CFR at low dose, as well as at peak dobutamine dose compared to patients in group 1 (1.55+/-0.5 vs. 2.03+/-0.6, p<0.008). CONCLUSION: CFV and CFR assessments are feasible during DSE with second harmonic imaging in most patients without use of contrast agent. CFR assessment during DSE correlates well with wall thickening and was able to detect ischemia early before development of wall motion abnormality.
Authors:
Saeed A L Ahmari; Karen Modesto; Jared Bunch; Vicky Stussy; Amy Dichak; James Seward; Patricia Pellikka; Krishnaswamy Chandrasekaran
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Publication Detail:
Type:  Journal Article     Date:  2005-06-29
Journal Detail:
Title:  European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology     Volume:  7     ISSN:  1525-2167     ISO Abbreviation:  Eur J Echocardiogr     Publication Date:  2006 Mar 
Date Detail:
Created Date:  2006-02-21     Completed Date:  2006-07-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100890618     Medline TA:  Eur J Echocardiogr     Country:  England    
Other Details:
Languages:  eng     Pagination:  134-40     Citation Subset:  IM    
Affiliation:
Echocardiography Lab, Cardiology division, Mayo Clinic, 200 First Street SW, Gonda 6-138 NW, Rochester, MN 55905, USA. naman45@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Blood Flow Velocity
Cardiotonic Agents / diagnostic use
Chi-Square Distribution
Contrast Media
Coronary Circulation / physiology*
Dobutamine / diagnostic use
Echocardiography, Stress*
Feasibility Studies
Female
Humans
Male
Myocardial Ischemia / physiopathology,  ultrasonography*
Prospective Studies
ROC Curve
Chemical
Reg. No./Substance:
0/Cardiotonic Agents; 0/Contrast Media; 34368-04-2/Dobutamine

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


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