Document Detail


Validation of viability assessment by electromechanical mapping by three-dimensional reconstruction with dobutamine stress echocardiography in patients with coronary artery disease.
MedLine Citation:
PMID:  15110199     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We evaluated the ability of electromechanical mapping (EMM) to discriminate between normal, viable, and nonviable (scarred) myocardium in patients with coronary artery disease versus dobutamine stress echocardiography (DSE) when the correspondence between the test and reference data sets is established via a common 3-dimensional reconstruction of the left ventricle. We studied 21 patients with coronary artery disease who underwent angiography, biplane ventriculography, and EMM within 1 month of DSE. A 3-dimensional left ventricular (LV) reconstruction was prepared from the ventriculogram and spatially aligned with EMM. EMM measurements of unipolar voltage, bipolar voltage, and local linear shortening were projected onto the three-dimensional left ventricle, averaged in each of 16 segments, and compared with DSE viability (normal, viable, scar) assessed at a core laboratory. All of the EMM measurements varied significantly (p <0.001) between the normal, viable, and scarred myocardium as assessed by DSE. Local linear shortening for normal, viable, and scarred segments was 10.4 +/- 6.5%, 7.8 +/- 5.6%, and 4.8 +/- 4.4%, respectively. In discriminating between these 3 groups, local linear shortening was more powerful than unipolar voltage or bipolar voltage (F = 20.765, F = 10.655, F = 4.795, respectively). Local linear shortening correlated best with viability, perhaps because it shares the same cognitive function as DSE. Three-dimensional analysis provides an anatomic framework that enables direct comparison of data from multiple imaging modalities rather than assuming segmental correspondence. Our results show that EMM provides significant on-line, diagnostic information on myocardial viability assessed by DSE on a segment-by-segment basis.
Authors:
Athena Poppas; Florence H Sheehan; Mark Reisman; Verna Harms; Ran Kornowski
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't; Validation Studies    
Journal Detail:
Title:  The American journal of cardiology     Volume:  93     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2004 May 
Date Detail:
Created Date:  2004-04-27     Completed Date:  2004-06-08     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1097-101     Citation Subset:  AIM; IM    
Affiliation:
Rhode Island Hospital Cardiology, Brown University Medical School, Providence, Rhode Island, USA. Athena_Poppas_MD@brown.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Body Surface Potential Mapping*
Coronary Angiography
Coronary Artery Disease / diagnosis*,  epidemiology,  physiopathology
Echocardiography, Stress*
Female
Heart Catheterization
Heart Ventricles / physiopathology,  radiography,  ultrasonography
Humans
Image Enhancement
Imaging, Three-Dimensional*
Male
Middle Aged
Multivariate Analysis
Observer Variation
Severity of Illness Index
Stroke Volume / physiology

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


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