Document Detail


Regional response of myocardial acceleration during isovolumic contraction during dobutamine stress echocardiography: a color tissue Doppler study and comparison with angiocardiographic findings.
MedLine Citation:
PMID:  16343161     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Color tissue Doppler imaging permits noninvasive quantitation of regional wall motion. In experimental studies, a new marker, the slope of the isovolumic contraction wave, isovolumic acceleration (IVA) was more insensitive to ventricular loading conditions than myocardial velocities. This study compared the regional response IVA to dobutamine stress echocardiography to angiographic findings. METHODS: The Myocardial Doppler in Stress Echocardiography (MYDISE) study prospectively recruited 149 consecutive patients with chest pain for dobutamine stress tissue Doppler echocardiography prior to coronary angiography. This color tissue Doppler database was analyzed for IVA in 1,192 basal and mid segments at rest and again at peak stress. Angiographic findings were compared to IVA and peak systolic velocities (PSV) in corresponding cardiac segments. The diagnostic accuracy of IVA to predict coronary artery stenosis was determined using cut-off values for three representative segments and with the MYDISE diagnostic model including eight segments. RESULTS: Regional IVA increased in a dose-dependent manner during dobutamine infusion. The response was blunted in the supply territory of stenosed coronary artery branches. IVA performed slightly better than PSV as single marker for coronary artery stenosis. A diagnostic model incorporating IVA and PSV was 85-95% accurate (area under receiver operating characterstic curves). CONCLUSIONS: Regional changes of isovolumic acceleration during dobutamine stress echocardiography reflect regional wall motion and can be used to predict coronary artery stenosis with similar accuracy as a model based on systolic myocardial velocities. As a single marker, IVA performed better than myocardial velocities.
Authors:
Linda B Pauliks; Michael Vogel; Christoph F M?dler; R Ian Williams; Nicola Payne; Andrew N Redington; Alan G Fraser
Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Echocardiography (Mount Kisco, N.Y.)     Volume:  22     ISSN:  0742-2822     ISO Abbreviation:  Echocardiography     Publication Date:  2005 Nov 
Date Detail:
Created Date:  2005-12-13     Completed Date:  2006-05-08     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8511187     Medline TA:  Echocardiography     Country:  United States    
Other Details:
Languages:  eng     Pagination:  797-808     Citation Subset:  IM    
Affiliation:
Tufts-New England Medical Center, 750 Washington Street, Boston, Massachusetts 02115, USA. lpauliks@tufts-nemc.org
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MeSH Terms
Descriptor/Qualifier:
Acceleration
Angiocardiography / methods
Blood Flow Velocity / physiology
Chest Pain / etiology
Cohort Studies
Coronary Stenosis / diagnosis
Dobutamine / diagnostic use
Echocardiography, Doppler, Color / methods*
Echocardiography, Stress / methods*
Female
Humans
Male
Middle Aged
Myocardial Contraction / physiology*
Predictive Value of Tests
Prospective Studies
Regional Blood Flow / physiology
Reproducibility of Results
Sensitivity and Specificity
Chemical
Reg. No./Substance:
34368-04-2/Dobutamine

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


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