Document Detail

The Sensitivity of Exercise Echocardiography Can Be Improved by Taking the Delayed Myocardial Contraction into Account.
MedLine Citation:
PMID:  11175047     Owner:  NLM     Status:  Publisher    
The purpose of this study was to test whether the systolic myocardial wall motion abnormalities at the early stages of ischemia are applicable to the diagnosis of coronary artery disease. Forty-four patients with suspected coronary artery disease were studied with the use of low-level exercise echocardiography. Exercise was stopped at the onset of first cardiac symptoms, and no patient exceeded 70% of the age-predicted maximal heart rate level. Forty patients had significant stenosis in at least one coronary artery on coronary angiography. Ten control subjects with a low probability of ischemic heart disease also were studied with exercise echocardiography. The first ischemic wall motion abnormality in systole, defined as delayed onset of the contraction (a regional delay of at least 100 milliseconds in a frame-by-frame analysis of echocardiograms) without any reduction in systolic movement, was regarded separately from hypokinesis (systolic wall motion excursion of less than 5 mm). When the delayed onset of the contraction also was taken into account, 37 of the 40 patients with coronary artery disease had an ischemic response after exercise. The sensitivity of the test thus was 93%. The reduction in systolic wall movement was detected in only 18 of these patients at the exercise level attained (70% or less of age-predicted maximal heart rate). There were two false-positive echocardiograms, but when the control group also was considered, the specificity of the test remained high at 86%. The sensitivity of exercise echocardiography can be increased by paying attention to the delayed onset of the systolic contraction, which occurs at the early stages of ischemia.
Matti Luotolahti; Markku Saraste; Liisa-Maria Voipio-Pulkki; Jaakko Hartiala
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Publication Detail:
Journal Detail:
Title:  Echocardiography (Mount Kisco, N.Y.)     Volume:  15     ISSN:  1540-8175     ISO Abbreviation:  Echocardiography     Publication Date:  1998 May 
Date Detail:
Created Date:  2001-Feb-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8511187     Medline TA:  Echocardiography     Country:  -    
Other Details:
Languages:  ENG     Pagination:  345-352     Citation Subset:  -    
Department of Clinical Physiology, Turku University Hospital, Kiinamyllynkatu 4-8, FIN-20520 Turku, Finland.
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