title: Diastolic response during dobutamine stress echocardiography evaluated by a tissue velocity imaging technique is a sensitive indicator for diagnosing coronary artery disease.
abstract: BACKGROUND
  Tissue velocity imaging (TVI) is a new method that measures regional myocardial velocities on the basis of color Doppler myocardial imaging principles.
  
  
  METHODS
  To diagnose coronary artery disease (CAD) objectively by evaluating left ventricular diastolic responses during dobutamine stress echocardiography (DSE) with TVI, we performed DSE in 22 healthy participants and 28 patients with angina pectoris without wall-motion abnormality at rest. Before and during DSE, we measured the differences of time intervals from the R wave on electrocardiogram to the peak of early diastolic myocardial velocity in the same cardiac cycle between basal segments and midsegments in the septal (dT-S) and inferior (dT-I) walls by TVI.
  
  
  RESULTS
  During DSE, dT-S in patients with left anterior descending CAD and dT-I in patients with right CAD were prolonged compared with that in healthy participants (both P <.01). The localization of the segments with a dT-S or dT-I during low-dose (10 microg/kg/min) dobutamine infusion of >32 milliseconds allowed the correct identification of the stenosed vessel in 87% of 23 patients for whom DSE was performed with the TVI technique before coronary angiography.
  
  
  CONCLUSIONS
  The analysis of regional left ventricular diastolic responses to dobutamine stress using TVI was useful for the objective diagnosis of CAD.
authors.affiliation: Department of Cardiovascular Medicine, Yamaguchi University School of Medicine, Minami-Kogushi, Ube, Japan.
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Wada
authors.forename: Kazuya
authors.initials: K
authors.lastname: Murata
authors.forename: Kazumi
authors.initials: K
authors.lastname: Kimura
authors.forename: Kayo
authors.initials: K
authors.lastname: Ueda
authors.forename: Jinyao
authors.initials: J
authors.lastname: Liu
authors.forename: Rikimaru
authors.initials: R
authors.lastname: Oyama
authors.forename: Nozomu
authors.initials: N
authors.lastname: Harada
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Tanaka
authors.forename: Akira
authors.initials: A
authors.lastname: Takaki
authors.forename: Masunori
authors.initials: M
authors.lastname: Matsuzaki
mesh_terms: D000368:Aged; D001783:Blood Flow Velocity; D001794:Blood Pressure / Q000502:physiology; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology; D003971:Diastole; D025401:Echocardiography, Stress; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000503:physiopathology