Quantitative analysis of dobutamine-atropine stress echocardiography.
OBJECTIVE
To investigate the usefulness of fractional area change of entire left ventricular areas obtained from apical views for quantitative analysis of dobutamine-atropine stress echocardiography in the presence of mild to moderately reduced left ventricular function and abnormal intra-thoracic heart motion after coronary artery bypass surgery.


RESULTS
Stress echocardiograms from 38 echogenic patients before and 3 months after bypass surgery and from 44 echogenic healthy subjects were analysed. In successfully revascularized patients the fractional area change at peak stress was correlated to the baseline left ventricular ejection fraction (r=0.54, P<0.01), whereas the increase from baseline to peak stress was constant over a wide range of baseline ejection fractions. With respect to identifying the pre-revascularization examination as diseased, the area under the receiver operator characteristics curve based on Delta fractional area change from baseline to peak stress was 0.78 (95% CI 0.55-1.00) indicating moderate accuracy comparable with the results obtained with conventional analysis.


CONCLUSIONS
Fractional area change of entire left ventricular cavity areas is a useful parameter for quantitative analysis of dobutamine-atropine stress echocardiography. The diagnostic properties of the parameter are not offset by moderate reduction in left ventricular function or by surgery-induced abnormal intra-thoracic heart motion.
Carstensen
S
S
Department of Medicine B 2142, The Heart Centre at Rigshospitalet, University of Copenhagen, Blegdamsvej 9, Copenhagen, Denmark. sc@dadlenet.dk
Høst
U
U
Saunamäki
K
K
Kelbaek
H
H
D000318:Adrenergic beta-Agonists; D000328:Adult; D000368:Aged; D000889:Anti-Arrhythmia Agents; D001285:Atropine; D001794:Blood Pressure / Q000502:physiology; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D004280:Dobutamine; D025401:Echocardiography, Stress; D005260:Female; D005500:Follow-Up Studies; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013318:Stroke Volume / Q000502:physiology; D013599:Systole / Q000502:physiology; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery
D000318:Adrenergic beta-Agonists; D000889:Anti-Arrhythmia Agents; D004280:Dobutamine; D001285:Atropine