title: Pulsed tissue Doppler imaging for the detection of myocardial ischaemia, a comparison with myocardial perfusion SPECT.
abstract: In order to compare the diagnostic ability of pulsed tissue Doppler and myocardial perfusion Single Photon Emission Computed Tomography (SPECT) in patients with a history of unstable coronary artery disease, CAD, 26 patients, 22 men and four women, age 47-76 years, were investigated in a prospective study, 5-10 day after an episode of unstable angina. Tissue Doppler and two-dimensional echocardiography were performed during dobutamine stress testing and myocardial scintigraphy after bicycle exercise and at rest. Patients with a normal SPECT had higher peak systolic velocity during dobutamine infusion, 18.9 +/- 4.1 cm s(-1), than patients with ischaemia, 12.2 +/- 3.8 cm s(-1) (P<0.001) or scar, 8.8 +/- 3.0 cm s(-1) (P<0.01). In a territorial analysis the difference in peak systolic velocity between areas with a normal and abnormal SPECT was less apparent. Failure to achieve >/=13 cm s(-1) in mean-peak systolic velocity was the most accurate criterion for detection of significant CAD on SPECT. We conclude that pulsed tissue Doppler can be used for objective quantification of left ventricular wall motion during dobutamine stress testing and for identification of patients with CAD on SPECT but not for identification of regional ischaemia.
authors.affiliation: Department of Clinical Physiology, County Hospital Ryhov, 551-85 Jönköping, Sweden.
authors.forename: Peter
authors.initials: P
authors.lastname: Blomstrand
authors.forename: Eva
authors.initials: E
authors.lastname: Maret
authors.forename: Jan
authors.initials: J
authors.lastname: Ohlsson
authors.forename: Morten
authors.initials: M
authors.lastname: Scheike
authors.forename: Jan-Erik
authors.initials: JE
authors.lastname: Karlsson
authors.forename: Kåge
authors.initials: K
authors.lastname: Säfström
authors.forename: Eva
authors.initials: E
authors.lastname: Swahn
authors.forename: Jan
authors.initials: J
authors.lastname: Engvall
mesh_terms: D000368:Aged; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging*; D004280:Dobutamine; D018619:Echocardiography, Doppler, Pulsed / Q000379:methods; D025401:Echocardiography, Stress / Q000379:methods; D005080:Exercise Test / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging* / Q000209:etiology; D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology
chemical_list: D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; D004280:Dobutamine; C078700:technetium tc-99m tetrofosmin