Document Detail


Sensitive method of detecting myocardial ischemia during dobutamine stress echocardiography.
MedLine Citation:
PMID:  12655162     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To test the hypothesis that dobutamine-induced myocardial ischemia causes early-systolic asynchrony predominantly in the regional left ventricular wall, color kinesis (CK) images during dobutamine stress echocardiography (DSE) were recorded in 13 patients with coronary artery disease and in 10 patients without, all of whom showed normal wall motion at rest. Based on the visual interpretation of DSE and the angiographic findings, 21 segments in the short-axis images at the papillary muscle level were defined as ischemic, and 60 segments of the patients without coronary artery disease were defined as normal. The incremental fractional segmental area change (IFAC) was calculated at 33-ms intervals from the CK images. At the peak dose, IFACs during the first 33 and 33-67 ms were significantly lower in the ischemic segments than in the normal ones, and IFACs during 133-167, 200-233 and 233-267 ms were significantly higher in the ischemic segments. The ratio (peak/low dose) of the cumulative fractional area change at 100 ms gave the best sensitivity (= specificity) for differentiating the 2 groups (86%). Dobutamine-induced ischemia is characterized by an early-systolic asynchrony rather than a change in overall wall excursion and CK can provide an objective assessment of ischemia developing during DSE.
Authors:
Satoshi Yamada; Taisei Mikami; Kaoru Komuro; Hisao Onozuka; Naotaka Saito; Keiko Nishihara; Kazushi Urasawa; Akira Kitabatake
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  67     ISSN:  1346-9843     ISO Abbreviation:  Circ. J.     Publication Date:  2003 Apr 
Date Detail:
Created Date:  2003-03-25     Completed Date:  2003-10-08     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  317-22     Citation Subset:  IM    
Affiliation:
Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan. syamada@med.hokudai.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Aged
Cardiotonic Agents / diagnostic use
Case-Control Studies
Dobutamine / diagnostic use*
Echocardiography
Echocardiography, Stress*
Female
Heart / physiopathology*
Humans
Male
Middle Aged
Myocardial Ischemia / physiopathology*,  ultrasonography*
Systole
Ventricular Function, Left
Chemical
Reg. No./Substance:
0/Cardiotonic Agents; 34368-04-2/Dobutamine

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


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