title: [Estimation of myocardial ischemia by diastolic strain analysis in exercise stress echocardiography: comparison with exercise thallium-201 single photon emission computed tomography].
abstract: OBJECTIVE
  The feasibility of detecting persistent regional left ventricular abnormal relaxation due to myocardial ischemia using strain echocardiography several minutes after exercise was investigated.
  
  
  METHODS
  Consecutive 27 patients (mean age 65 +/- 9 years, 21 males, 6 females) with suspected coronary artery disease were enrolled. Strain echocardiographic images were acquired at the mid segments of the left ventricular wall before and 5 min after exercise in the apical long-axis, two-chamber and four-chamber views. Strain curves were obtained at each segment, and peak values of strain at the closure of aortic valve (A) and at one third of diastolic duration (B) were measured. Strain diastolic index (SDI) was calculated as (A - B)/A X 100%. The ratio of SDI before exercise to that after exercise was defined as the SDI ratio and compared with exercise thallium-201 single photon emission computed tomography (SPECT) as the reference standard to detect myocardial ischemia.
  
  
  RESULTS
  A total of 162 segments were evaluated. Based on the results of exercise SPECT, 119 segments were classified as non-ischemic segments, and 43 as ischemic segments. Ischemic segments showed significant decreases in SDI before and after exercise, whereas non-ischemic segments showed no significant differences in SDI before and after exercise. SDI ratio was significantly decreased in ischemic segments, but not in non-ischemic segments. SDI ratio with a cut off value of 0.51 had a sensitivity of 91% and a specificity of 89% to detect myocardial ischemia in the receiver-operating characteristics. Conclusions. Strain echocardiography can provide quantitative assessment of myocardial ischemia by detecting post-ischemic regional left ventricular delayed relaxation even 5 min after exercise.
authors.affiliation: Department of Internal Medicine and Cardiology, Osaka City University Graduate School of Medicine, Osaka.
authors.forename: Hong
authors.initials: H
authors.lastname: Zhu
authors.forename: Takeshi
authors.initials: T
authors.lastname: Hozumi
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Takemoto
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Takagi
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Negishi
authors.forename: Koji
authors.initials: K
authors.lastname: Abo
authors.forename: Kenichi
authors.initials: K
authors.lastname: Sugioka
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Matsumura
authors.forename: Ryo
authors.initials: R
authors.lastname: Otsuka
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Yoshitani
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Nakao
authors.forename: Minoru
authors.initials: M
authors.lastname: Yoshiyama
authors.forename: Junichi
authors.initials: J
authors.lastname: Yoshikawa
mesh_terms: D000368:Aged; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000503:physiopathology; D003971:Diastole; D025401:Echocardiography, Stress; D005080:Exercise Test; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis* / Q000503:physiopathology; D013794:Thallium Radioisotopes; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D013794:Thallium Radioisotopes