Tissue Doppler echocardiography improves the diagnosis of coronary artery stenosis in stable angina pectoris.
Aim To determine if colour tissue Doppler imaging (TDI) performed at rest in patients with suspected stable angina pectoris (SAP) is able to predict the presence of significant coronary artery disease (CAD).


RESULTS
This study comprises 296 consecutive patients with clinically suspected SAP, no previous cardiac history, and a normal ejection fraction. All patients were examined by colour TDI, exercise electrocardiogram (ECG), and coronary angiography (CAG). Regional longitudinal systolic (s'), early diastolic (e'), and late diastolic (a') myocardial velocities were measured by colour TDI at six mitral annular sites and averaged to provide global estimates. Duke score (DS), including ST depression, chest pain, and exercise capacity, was used as the outcome of the exercise ECG. Patients with an area stenosis of ≥70% in at least one epicardial coronary artery were categorized as having a significant CAD (n= 108) and were compared with patients without significant CAD (n= 188). Both e' [odds ratio (OR): 1.5 (1.1-1.9, P < 0.01) per cm/s decrease] and s' [OR: 1.7 (1.1-2.5, P < 0.05) per cm/s decrease] remained independent predictors of CAD after multivariable adjustment for baseline, exercise ECG, and conventional echocardiographic parameters. Area under the receiver operating characteristic curve (AUC) for exercise ECG and TDI in combination was significantly higher than AUC for exercise ECG alone (0.84 vs. 0.79, P < 0.01).


CONCLUSIONS
In patients with suspected SAP colour TDI performed at rest is an independent predictor of significant CAD, and colour TDI improves the diagnostic performance of exercise ECG.
Department of Cardiology, Gentofte University Hospital, Post 4210, 65 Niels Andersens Vej, DK-2900 Hellerup, Copenhagen, Denmark. klewser@gmail.com
Soren
S
Hoffmann
Jan Skov
JS
Jensen
Allan Zeeberg
AZ
Iversen
Peter
P
Sogaard
Soren
S
Galatius
Niels Thue
NT
Olsen
Jan
J
Bech
Thomas
T
Fritz-Hansen
Tor
T
Biering-Sorensen
Jorn
J
Badskjaer
Adrian
A
Pietersen
Rasmus
R
Mogelvang
D060050:Angina, Stable / Q000000981:diagnostic imaging*; D016009:Chi-Square Distribution; D015897:Comorbidity; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000000981:diagnostic imaging*; D018618:Echocardiography, Doppler, Color / Q000379:methods; D004562:Electrocardiography; D005080:Exercise Test; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012372:ROC Curve