We investigated whether multiplane transesophageal echocardiography with the use of tissue Doppler imaging (TDI, Toshiba corp.) during graded dobutamine infusion may be useful to detect and quantify stress induced myocardial ischemia by changes in myocardial velocities. 41 pts, aged 52±9 years, were studied with transesophageal dobutamine stress echocardiography (T-DSE) and TDI. Midesophageal and transgastric short- and long-axis images were obtained at each level of dobutamine infusion up to 50/Kg/min; 0.5mg of atropine was given intravenously if 85% of the predicted maximal heart rate was not attained. T-DSE was successful in 39 pts (95%). There were no adverse outcomes or complications. High quality TDI data were available from all pts. Baseline resting peak systolic (S) and early diastolic (E) velocities of the anterior (AW), septal (SW), lateral (LW) and inferior walls (IW) were examined. 16 pts had a normal response to dobutamine and 25 pts had inducible ischemia by 2D criteria. The abnormal group had angiographic evidence (stenosis >75%) of coronary artery disease (CAD). In the normal group there was a significant dose dependent increase in S and E velocities (S:AW 5.2 to 10.7 cm/s, SW 7.1 to 14.2 cm/s, LW 7.3 to 13.9 cm/s, IW 6.7 to 13.6 cm/s -p<0.001-; E: AW –5.7 to –9.8 cm/s, SW –6.8 to –11.9 cm/s, LW –6.5 to –11.9 cm/s, IW –5.6 to –10.4 cm/s -p<0.0005-). Compared to normals, patients with CAD had lower resting S and E velocities and a blunted increase during DSE (S: AW 4.1 to 7.5 cm/s, SW 6.4 to 8.3 cm/s, LW 6.2 to 9.2 cm/s, IW 5.5 to 8.5 -p<0.001 vs control-; E: AW –3.8 to –5.9 cm/s, SW –5.8 to –7.6 cm/s, LW –6.2 to –8.6 cm/s, IW –5.2 to –7.5 cm/s -p<0.001 vs control-). Thus, T-DSE with TDI is a feasible and accurate test for the quantitative assessment of patients with CAD that have impaired augmentation of systolic and diastolic myocardial velocities during dobutamine infusion.
TRANSESOPHAGEAL DOBUTAMINE STRESS ECHOCARDIOGRAPHY WITH TISSUE DOPPLER IMAGING FOR DETECTION AND ASSESSMENT OF CORONARY ARTERY DISEASE / Vitarelli, Antonino; Conde, Y; Giubieli, R; Cortes, M; DI BENEDETTO, Giulia. - In: JOURNAL OF CARDIAC FAILURE. - ISSN 1071-9164. - STAMPA. - 5/3 (Suppl 1):(1999), p. 11. (Intervento presentato al convegno 3TH ANNUAL MEETING OF HEART FAILURE SOCIETY OF AMERICA, SAN FRANCISCO tenutosi a San Francisco, USA nel Sept 22-26, 1999).
TRANSESOPHAGEAL DOBUTAMINE STRESS ECHOCARDIOGRAPHY WITH TISSUE DOPPLER IMAGING FOR DETECTION AND ASSESSMENT OF CORONARY ARTERY DISEASE
VITARELLI, Antonino;DI BENEDETTO, GIULIA
1999
Abstract
We investigated whether multiplane transesophageal echocardiography with the use of tissue Doppler imaging (TDI, Toshiba corp.) during graded dobutamine infusion may be useful to detect and quantify stress induced myocardial ischemia by changes in myocardial velocities. 41 pts, aged 52±9 years, were studied with transesophageal dobutamine stress echocardiography (T-DSE) and TDI. Midesophageal and transgastric short- and long-axis images were obtained at each level of dobutamine infusion up to 50/Kg/min; 0.5mg of atropine was given intravenously if 85% of the predicted maximal heart rate was not attained. T-DSE was successful in 39 pts (95%). There were no adverse outcomes or complications. High quality TDI data were available from all pts. Baseline resting peak systolic (S) and early diastolic (E) velocities of the anterior (AW), septal (SW), lateral (LW) and inferior walls (IW) were examined. 16 pts had a normal response to dobutamine and 25 pts had inducible ischemia by 2D criteria. The abnormal group had angiographic evidence (stenosis >75%) of coronary artery disease (CAD). In the normal group there was a significant dose dependent increase in S and E velocities (S:AW 5.2 to 10.7 cm/s, SW 7.1 to 14.2 cm/s, LW 7.3 to 13.9 cm/s, IW 6.7 to 13.6 cm/s -p<0.001-; E: AW –5.7 to –9.8 cm/s, SW –6.8 to –11.9 cm/s, LW –6.5 to –11.9 cm/s, IW –5.6 to –10.4 cm/s -p<0.0005-). Compared to normals, patients with CAD had lower resting S and E velocities and a blunted increase during DSE (S: AW 4.1 to 7.5 cm/s, SW 6.4 to 8.3 cm/s, LW 6.2 to 9.2 cm/s, IW 5.5 to 8.5 -p<0.001 vs control-; E: AW –3.8 to –5.9 cm/s, SW –5.8 to –7.6 cm/s, LW –6.2 to –8.6 cm/s, IW –5.2 to –7.5 cm/s -p<0.001 vs control-). Thus, T-DSE with TDI is a feasible and accurate test for the quantitative assessment of patients with CAD that have impaired augmentation of systolic and diastolic myocardial velocities during dobutamine infusion.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
