title: Effects of atrial pacing stress test on ultrasonic integrated backscatter cyclic variations in normal subjects and in patients with coronary artery disease.
abstract: OBJECTIVE
  To evaluate the effects of acute, atrial pacing-induced, reversible myocardial ischaemia on myocardial thickening and integrated backscatter cyclic variations in patients with or without coronary artery disease.
  
  
  RESULTS
  Thirty-six patients with suspected coronary artery disease underwent transoesophageal echocardiography with simultaneous atrial pacing, and coronary angiography. In myocardial segments not related to a significantly narrowed coronary artery, both from patients with and without coronary artery disease, thickening and integrated backscatter cyclic variations were not reduced at peak pacing. In segments related to a significantly narrowed coronary artery, thickening decreased at peak pacing, was still reduced at pacing interruption and recovered at 2 min, while backscatter cyclic variations, blunted at peak pacing, immediately recovered after pacing interruption.
  
  
  CONCLUSIONS
  During stress-induced myocardial ischaemia, backscatter cyclic variations are blunted and thickening reduced. Returning to baseline, pre-atrial pacing values occur more rapidly in backscatter cyclic variations than when thickening takes place. Evaluation of stress-induced alterations in backscatter cyclic variations may aid in the identification of ischaemia-induced regional left ventricular functional impairment and, hence, in coronary artery disease diagnosis.
authors.affiliation: Institute of Cardiology, University of Bari, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Iliceto
authors.forename: L
authors.initials: L
authors.lastname: Galiuto
authors.forename: P
authors.initials: P
authors.lastname: Colonna
authors.forename: V F
authors.initials: VF
authors.lastname: Napoli
authors.forename: P
authors.initials: P
authors.lastname: Rizzon
mesh_terms: D016275:Atrial Function; D006328:Cardiac Catheterization; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology; D017548:Echocardiography, Transesophageal / Q000379:methods*; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D015588:Observer Variation; D015203:Reproducibility of Results; D016276:Ventricular Function