Document Detail

Regional diastolic and systolic function by strain rate imaging for the detection of intramural viability during dobutamine stress echocardiography in a porcine model of myocardial infarction.
MedLine Citation:
PMID:  20345444     Owner:  NLM     Status:  MEDLINE    
The aim of this study was to evaluate diastolic and systolic strain rate measurements for differentiation of transmural/nontransmural infarction during dobutamine stress echocardiography (DSE). An ameroid constrictor was placed around the circumflex artery in 23 pigs inducing chronic vessel occlusion. Five pigs without constrictor served as controls. During high-dose DSE systolic strain rates (SR(sys)), systolic and postsystolic strain values (epsilon(sys), epsilon(ps)) and early and late diastolic strain rates (SR(E) and SR(A)) were determined. At week 6, animals were evaluated regarding myocardial fibrosis. Histology revealed nontransmural in 14 and transmural infarction in 9 animals. In controls, dobutamine induced a linear increase of SR(sys) to 12.3 + or - 0.4 s(-1) at 40 microg/kg per minute (P = 0.001) and a linear decrease of SR(E) to -6.6 + or - 0.3 s(-1) (P = 0.001). In the nontransmural group, SR(sys), epsilon(sys), epsilon(ps) at rest, and during DSE were higher and SR(E) was lower than in the transmural infarction group (P = 0.01). Best predictors for viability were SR(sys) (ROC 0.96, P = 0.0003), SR(E) at 10 microg/kg per minute dobutamine stimulation (ROC 0.94, P = 0.001) and positive SR values during isovolumetric relaxation at 40 microg/kg per minute dobutamine (ROC 0.86, P = 0.004). The extension of fibrosis correlated with SR(sys) at rest, epsilon(sys) at rest, and SR(E) at rest (P < 0.001). For the detection of viability similar diagnostic accuracies of SR(E) and SRsys were seen (sensitivity 93%/93%, specificity 96%/94%, respectively). Diastolic SR analysis seems to be equipotent for the identification of viable myocardium in comparison to systolic SR parameters and allows the differentiation of nontransmural from transmural myocardial infarction with high diagnostic accuracy. (Echocardiography 2010;27:552-562).
Carsten Schneider; Kai Jaquet; Stephan Geidel; Rainer Malisius; Sigrid Boczor; Thomas Rau; Tomacz Zienkiewicz; Detlef Hennig; Karl-Heinz Kuck; Korff Krause
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Publication Detail:
Type:  Journal Article     Date:  2010-03-25
Journal Detail:
Title:  Echocardiography (Mount Kisco, N.Y.)     Volume:  27     ISSN:  1540-8175     ISO Abbreviation:  Echocardiography     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-07-08     Completed Date:  2010-10-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8511187     Medline TA:  Echocardiography     Country:  United States    
Other Details:
Languages:  eng     Pagination:  552-62     Citation Subset:  IM    
Department of Cardiology, St. Georg Hospital, Hamburg, Germany.
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MeSH Terms
Dobutamine / diagnostic use
Echocardiography, Stress / methods*
Fibrosis / ultrasonography
Image Processing, Computer-Assisted
Linear Models
Myocardial Infarction / pathology,  ultrasonography*
ROC Curve
Statistics, Nonparametric
Reg. No./Substance:

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