The additive value of three-dimensional derived left atrial volume and carotid imaging in dobutamine stress echocardiography.
OBJECTIVE
to evaluate whether the three-dimensional (3D) left atrial volume index (LAVI) and/or the presence of carotid plaques (CP) can predict the result of dobutamine stress echocardiography (DSE), thereby aiding interpretation.


RESULTS
we studied 130 patients (52 male, mean age 63 ± 11 years) with normal resting wall motion (WM) undergoing DSE. All patients had the end-systolic 2D and 3D LAVI measured, as well as bilateral carotid scanning. DSE was reported as abnormal in 50 (38.5%) patients. 3D end-systolic LAVI measurements were significantly higher (31.5 ± 8.2 vs 27.4 ± 7.4 mL/m(2), P = 0.004) in those with an abnormal DSE. The two groups did not differ significantly on the 2D derived maximum LAVI measurements (36.2 ± 9.5 vs 34.2 ± 11.2, P = 0.299) and the presence of plaques in the carotid arteries (89.1 vs. 76.2%, P = 0.100). Receiver operating characteristic curves were created to define cut-offs that could predict the DSE result for the 3D LAVI. A 3D LAVI of >24.5 mL/m(2) had a sensitivity of 80% for predicting an abnormal DSE, whereas a value of >36.0 mL/m(2) had a specificity of 93% for the same cause. Intra-observer (r = 0.997, P < 0.0001) and inter-observer (r = 0.961, P < 0.0001) variability for 3D LAVI measurements was found to be excellent.


CONCLUSIONS
three-dimensional (but not 2D) assessment of LAVI may offer additional information in predicting the result of DSE. Carotid scanning did not offer additional information for the same cause.
Sachpekidis
Vasileios
V
Department of Non-Invasive Cardiology, King's College Hospital, Denmark Hill, London SE5 9RS, UK.
Bhan
Amit
A
Paul
Matthias
M
Gianstefani
Silvia
S
Smith
Lindsay
L
Reiken
Joseph
J
Walker
Nicola
N
Harries
Derek
D
Pearson
Peter
P
Monaghan
Mark J
MJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002637:Chest Pain / Q000000981:diagnostic imaging; D016009:Chi-Square Distribution; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D025401:Echocardiography, Stress; D019560:Echocardiography, Three-Dimensional; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012372:ROC Curve; D012680:Sensitivity and Specificity