Exercise echocardiography: feasibility and value for detection of coronary artery disease.
OBJECTIVE
To evaluate the feasibility and accuracy of exercise echocardiography (Ex-Echo) for the diagnosis of coronary artery disease (CAD) based on coronary angiography (CA).


METHODS
Forty-seven patients were found to have CAD and examined by upright exercise electrocardiography (Ex-ECG) on a treadmill within two weeks of CA. Before and immediately after exercise, the patients lay on a bed beside the treadmill in the left lateral position and parasternal long and short axis and apical two and four chamber views of the heart were acquired. Pre- and post-echocardiograms were analysed in a side-by-side multiple screen format on the imaging view and hypodynamic wall motion of the left ventricle after exercise was defined as Ex-Echo positive. The sensitivity, specificity and predictive accuracy of Ex-Echo and Ex-ECG were calculated on the basis of CA data.


RESULTS
Satisfactory echocardiograms were recorded in 46 patients after exercise. The success rate was 97.8%. Compared with Ex-ECG, Ex-Echo was more sensitive (87.5% vs 62.5%, P < 0.05), specific (92.8% vs 60.0%, P < 0.05) and accurate (89.4% vs 61.7%, P < 0.01). The concord of determining the number of diseased vessels between coronary angiography and Ex-Echo was 90.9% in single vessel disease and 45.0% in multiple vessel disease. Wall motion scoring index, however, was higher in multiple than in single vessel CAD.


CONCLUSIONS
Ex-Echo test is feasible and accurate in detecting CAD and wall motion scoring index is probably useful in distinguishing multiple from single vessel CAD.
Tian
J
J
General Hospital of Beijing, Command, PLA, Beijing.
Zhang
G
G
Wang
X
X
Cui
J
J
Xiao
J
J
D003327:Coronary Disease / Q000000981:diagnostic imaging*; D004452:Echocardiography; D005080:Exercise Test; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity