title: Early diastolic flow propagation velocity detects induced diastolic dysfunction during dobutamine stress echocardiography.
abstract: OBJECTIVE
  Diastolic dysfunction precedes systolic dysfunction during the development of myocardial ischemia. Detecting diastolic dysfunction during stress test for coronary artery disease (CAD) could improve diagnostic sensitivity of the test. Flow propagation velocity (FPV) derived from color M-mode Doppler has been proposed as a sensitive marker to detect diastolic dysfunction.
  
  
  METHODS
  The FPVs at baseline and at peak dobutamine infusion were measured using color M-mode Doppler during dobutamine stress echocardiography in 90 patients. The results are compared among the groups divided on the results of coronary angiography.
  
  
  RESULTS
  The FPV was similar at baseline among the groups. At peak dobutamine infusion, the FPV increased significantly in the non-CAD group (from 56 ± 19 cm/s to 66 ± 25 cm/s), whereas it failed to increase in the groups with CAD. As a result, the peak FPV was significantly lower in the groups with CAD than in the non-CAD group. Receiver operating characteristic analysis showed that the peak FPV and ΔFPV had good diagnostic property to detect CAD (the areas under the curves were 0.77 and 0.73, respectively). Adopting these FPV criteria, sensitivity of DSE was improved.
  
  
  CONCLUSIONS
  FPV measurement during DSE detects ischemic left ventricular diastolic dysfunction. Adding the assessment of peak FPV to conventional DSE increases the sensitivity and the ability to reliably exclude CAD.
authors.affiliation: Cardiology Section, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA. tkohara529@gmail.com
authors.forename: Takahiro
authors.initials: T
authors.lastname: Ohara
authors.forename: Yuji
authors.initials: Y
authors.lastname: Hashimoto
authors.forename: Makoto
authors.initials: M
authors.lastname: Suzuki
authors.forename: Akihiko
authors.initials: A
authors.lastname: Matsumura
authors.forename: Mitsuaki
authors.initials: M
authors.lastname: Isobe
mesh_terms: D000368:Aged; D001783:Blood Flow Velocity; D004280:Dobutamine; D018618:Echocardiography, Doppler, Color / Q000379:methods*; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013318:Stroke Volume; D014665:Vasodilator Agents
chemical_list: D014665:Vasodilator Agents; D004280:Dobutamine