title: Can regional strain and strain rate measurement be performed during both dobutamine and exercise echocardiography, and do regional deformation responses differ with different forms of stress testing?
abstract: BACKGROUND
  Regional strain (epsilon) and strain rate (SR) measurement could be the optimal approach to quantifying stress echocardiography images. However, signal noise could preclude their use. Study aims Our aim was to compare the feasibility of regional peak systolic (p) velocity (Vel), pSR/epsilon measurement, and their normal responses during upright (group 1, n = 10) and supine (group 2, n = 10) bicycle exercise and (group 3, n = 10) dobutamine stress.
  
  
  METHODS
  For each type of stress study, pVel/pSR/epsilon data were acquired at baseline, low (100-120 bpm), and peak (140-160 bpm) heart rate (HR); and during recovery.
  
  
  RESULTS
  During dobutamine pVel/pSR/epsilon were interpretable in >95% of segments at every stress stage, whereas in groups 1 and 2 pSR/epsilon responses were noninterpretable in >36% of segments (P <.0002). The highest proportions of data exclusions were from the lateral and anterior walls. In all groups, regional systolic pVel and SR values increased linearly and reached maximal value at peak HR (P <.0006 vs baseline). Pepsilon showed a biphasic response, initially increasing at low HR, and then remaining constant or falling at peak HR.
  
  
  CONCLUSIONS
  PSR/pepsilon quantification of stress echocardiography may currently be restricted to dobutamine as increased signal noise precludes adequate data acquisition during exercise. For all forms of stress both pSR and pVel increased linearly, whereas pepsilon response was biphasic as a result of the reduced filling at higher HRs.
authors.affiliation: Department of Cardiology, University Hospital Gasthuisberg, Leuven, Belgium.
authors.forename: Giedrius
authors.initials: G
authors.lastname: Davidavicius
authors.forename: Miroslaw
authors.initials: M
authors.lastname: Kowalski
authors.forename: R Ian
authors.initials: RI
authors.lastname: Williams
authors.forename: Jan
authors.initials: J
authors.lastname: D'hooge
authors.forename: Giovanni
authors.initials: G
authors.lastname: Di Salvo
authors.forename: Gilbert
authors.initials: G
authors.lastname: Pierre-Justin
authors.forename: Piet
authors.initials: P
authors.lastname: Claus
authors.forename: Frank
authors.initials: F
authors.lastname: Rademakers
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Herregods
authors.forename: Alan G
authors.initials: AG
authors.lastname: Fraser
authors.forename: Luc A
authors.initials: LA
authors.lastname: Pierard
authors.forename: Bart
authors.initials: B
authors.lastname: Bijnens
authors.forename: George R
authors.initials: GR
authors.lastname: Sutherland
mesh_terms: D000328:Adult; D001794:Blood Pressure; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology; D025401:Echocardiography, Stress / Q000379:methods*; D005080:Exercise Test; D005240:Feasibility Studies; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D013599:Systole