Document Detail


Use of tissue Doppler imaging to facilitate the prediction of events in patients with abnormal left ventricular function by dobutamine echocardiography.
MedLine Citation:
PMID:  14715337     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The extent of abnormality in patients with positive dobutamine echocardiography (DE) is predictive of risk, but the wall motion score (WMS) has low concordance among observers. We sought whether quantifying the extent of abnormal wall motion using tissue Doppler (TD) could guide risk assessment in patients with abnormal DE in 576 patients with known or suspected coronary artery disease; standard DE was combined with color TD imaging at peak dose. WMS was assessed by an expert observer and studies were identified as abnormal in the presence of >/=1 segments with resting or stress-induced wall motion abnormalities. Patients with abnormal DE had peak systolic velocity measured in each segment. Tissue tracking was used to measure myocardial displacement. Follow-up for death or infarction was performed after 16 +/- 12 months. Of 251 patients with abnormal DE, 22 patients died (20 from cardiac causes) and 7 had nonfatal myocardial infarctions. The average WMS in patients with events was 1.8 +/- 0.5, compared with 1.7 +/- 0.5 in patients without events (p = NS). The average systolic velocity in patients with events was 4.9 +/- 1.7 cm/s and 6.4 +/- 6.5 cm/s in the patients without events (p <0.001). The average tissue tracking in patients with events was 4.5 +/- 1.5 mm and was significant (5.7 +/- 3.1 mm) in those without events (p <0.001). Thus, TD is an alternative to WMS for quantifying the total extent of abnormal left ventricular function at DE, and appears to be superior for predicting adverse outcomes.
Authors:
Thomas H Marwick; Colin Case; Rodel Leano; Leanne Short; Terri Baglin; Peter Cain; Paul Garrahy
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of cardiology     Volume:  93     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2004 Jan 
Date Detail:
Created Date:  2004-01-12     Completed Date:  2004-02-11     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  142-6     Citation Subset:  AIM; IM    
Affiliation:
University of Queensland, Brisbane, Australia. tmarwick@soms.uq.edu.au
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MeSH Terms
Descriptor/Qualifier:
Coronary Disease / mortality*
Echocardiography, Doppler, Color
Echocardiography, Stress*
Female
Follow-Up Studies
Humans
Male
Middle Aged
Myocardial Contraction
Myocardial Infarction / epidemiology*
Predictive Value of Tests
Prognosis
Prospective Studies
Time Factors
Ventricular Dysfunction, Left / ultrasonography*

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


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