Document Detail

Which is the better method in detecting significant left anterior descending coronary artery stenosis during contrast-enhanced dobutamine stress echocardiography: coronary flow velocity reserve or wall-motion assessment?
MedLine Citation:
PMID:  12778021     Owner:  NLM     Status:  MEDLINE    
The diagnostic accuracy of dobutamine stress echocardiography (DSE) depends on wall-motion assessment. Coronary flow velocity reserve (CFVR) during DSE can be measured by transthoracic Doppler echocardiography. To investigate comparative diagnostic accuracy between wall-motion and CFVR assessment in the detection of significant left anterior descending coronary artery (LAD) stenosis, 274 patients underwent both contrast-enhanced DSE and coronary angiography. Intravenous contrast agent, Levovist, was injected to enhance left ventricular endocardial border delineation and coronary flow velocity in the LAD. Wall motion was assessed by standard technique, and CFVR was calculated as coronary flow velocity at peak dobutamine stress divided by baseline coronary flow velocity by transthoracic Doppler echocardiography. CFVR could be successfully obtained in 232 patients (feasibility, 85%). After excluding 14 patients with isolated diagonal stenosis, CFVR was significantly lower in 65 patients with significant LAD stenosis than it was in 153 patients without stenosis (1.62 +/- 0.56 vs 2.72 +/- 0.94, P <.001). CFVR < or = 2.0 had a 75% sensitivity, a 81% specificity, and a 79% diagnostic accuracy for detecting significant LAD stenosis, and these values were comparable with those by wall-motion analysis (sensitivity, 78%; specificity, 89%; and diagnostic accuracy, 86%). The measurement of CFVR in the LAD during DSE was feasible and the diagnostic accuracy of CFVR was equivalent to wall-motion assessment in the detection of LAD stenosis.
Masaaki Takeuchi; Chinami Miyazaki; Hidetoshi Yoshitani; Shinichiro Otani; Kazuo Sakamoto; Junichi Yoshikawa
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography     Volume:  16     ISSN:  0894-7317     ISO Abbreviation:  J Am Soc Echocardiogr     Publication Date:  2003 Jun 
Date Detail:
Created Date:  2003-06-02     Completed Date:  2003-09-17     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8801388     Medline TA:  J Am Soc Echocardiogr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  614-21     Citation Subset:  IM    
Department of Internal Medicine, Tane General Hospital, 1-2-31 Sakaigawa, Nishi-ku, Osaka 550-0024, Japan.
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MeSH Terms
Blood Flow Velocity / physiology
Contrast Media
Coronary Angiography
Coronary Circulation / physiology*
Coronary Stenosis / ultrasonography*
Echocardiography, Stress*
Middle Aged
Myocardial Contraction / physiology*
Polysaccharides / diagnostic use
Prospective Studies
Sensitivity and Specificity
Reg. No./Substance:
0/Contrast Media; 0/Polysaccharides; 127279-08-7/SHU 508

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