Functional diagnosis of coronary stenosis using tissue tracking provides best sensitivity and specificity for left circumflex disease: experience from the MYDISE (myocardial Doppler in stress echocardiography) study.
OBJECTIVE
To evaluate the diagnostic capacity of quantitative analysis of segmental longitudinal myocardial displacement images (tissue tracking, TT) during dobutamine stress echocardiography for the detection of patients with coronary artery disease (CAD).


RESULTS
TT-generated colour-coded maps of systolic segmental longitudinal displacement were obtained by post-processing of echocardiographic data from 105 patients with CAD and 90 low risk individuals selected from MYDISE database. Quantitative analysis of the distribution pattern of segmental displacement during dobutamine stress was most successful when a ratio of basal (high amplitude) to apical (low amplitude) colour-coded displacement bands (B/A ratio) was employed. Applied in four different left ventricular sectors, the B/A ratio provided a significant discrimination of patients with CAD (p<0.05 in the anterior and p<0.001 in the inferior wall) as assessed by receiver operating characteristic analysis. The procedure was most sensitive when applied in inferior wall for the detection of left circumflex coronary artery disease, the B/A ratio of 0.8 giving the best combination of sensitivity (77+/-8%) and specificity (77+/-5%) values.


CONCLUSIONS
Quantification of dobutamine stress echocardiography using TT is an efficient diagnostic approach and a valuable additional modality in functional cardiac imaging for the initial identification of patients suspected for CAD.
Saha
Samir
S
Department of Clinical Physiology, Karolinska University Hospital, Huddinge, SE-141 86 Stockholm, Sweden. samir.saha@labmed.ki.se
Nowak
Jacek
J
Storaa
Camilla
C
Mädler
C F
CF
Fraser
Alan
A
Roumina
Simin
S
Lind
Britta
B
Brodin
Lars-Ake
LA
D000318:Adrenergic beta-Agonists; D000704:Analysis of Variance; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging*; D004280:Dobutamine; D018618:Echocardiography, Doppler, Color / Q000379:methods*; D025401:Echocardiography, Stress; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D012680:Sensitivity and Specificity; D013599:Systole / Q000502:physiology; D016277:Ventricular Function, Left
D000318:Adrenergic beta-Agonists; D004280:Dobutamine