Positive isovolumic relaxation velocity detected by a spectral tissue Doppler mapping technique as an indicator of coronary artery disease: a prospective study.
BACKGROUND
A positive myocardial velocity during isovolumic relaxation phase (V(IR)) detected by spectral tissue Doppler imaging has been shown to indicate ischemic myocardium. We sought to examine the diagnostic value of positive V(IR) for detecting coronary artery disease (CAD) in patients with chest pain and apparently normal left ventricular contraction.


METHODS
A total of 138 patients (74 men, age 69 +/- 8 years) underwent spectral Doppler tissue imaging measurements at the annular and mid left ventricular levels in the apical 4- and 2-chamber views (8 points/patient) at rest in addition to standard echocardiography. Subsequently, patients underwent thallium-201 myocardial perfusion single photon emission computed tomography (n = 98) and/or coronary angiography (n = 60). The duration of positive V(IR) was also assessed. CAD was diagnosed by having more than 75% diameter stenosis in coronary angiography.


RESULTS
CAD was present in 41 patients (30%). The duration of positive V(IR) was distributed from 0 to 280 milliseconds with the median value of 100 milliseconds. Presence of positive V(IR) predicted CAD with sensitivity of 80% and specificity of 61%.


CONCLUSIONS
Positive V(IR) detected by spectral tissue Doppler imaging is a useful indicator of CAD in patients with apparently normal left ventricular contraction and chest pain.
Onishi
Toshinari
T
Cardiovascular Division, Kansai Rosai Hospital, Amagasaki, Hyogo, Japan. onishi@kanrou.net
Uematsu
Masaaki
M
Nanto
Shinsuke
S
Iida
Osamu
O
Morozumi
Takakazu
T
Kotani
Jun-ichi
J
Awata
Masaki
M
Nagata
Seiki
S
D000368:Aged; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods; D008297:Male; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging* / Q000209:etiology; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013318:Stroke Volume; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology