title: Assesment of myocardial ischemia by combination of tissue synchronisation imaging and dobutamine stress echocardiography.
abstract: OBJECTIVE
  Dobutamine stress echocardiography (DSE) is an important non-invasive imaging method for evaluating ischemia. However, wall motion interpretation can be impaired by the experience level of the interpreter and the subjectivity of the visual assessment. In our study we aimed to combine DSE and tissue syncronisation imaging to increase sensitivity for detecting ischemia.
  
  
  METHODS
  50 patients with indications for DSE were included in the study. In 25 patients we found DSE positive for ischemia and in the other 25 patients we found it to be negative. The negative group was accepted as the control group. There was no significant difference in terms of risk factors and echocardiographic parameters between the two groups, except for wall motion scores. In both groups, left ventricular dyssychrony was accepted as the difference between time to peak systolic velocity (Ts) in the reciprocal four couple of non-apical segments at rest and during peak stress. Timings were corrected for heart rate. We compared the differences of the dyssynchronisation value at rest and during peak stress to determine the distinctions within the groups and between the groups of DSE positive and negative patients.
  
  
  RESULTS
  We found that stress and ischemia did not create any significant difference over the left intraventricular dyssynchrony with DSE, although at the segmenter level it prolonged the time to peak systolic velocity (p<0.05). These alterations did not show any significant difference between positive and negative DSE groups.
  
  
  CONCLUSIONS
  As a result, this segmenter dyssynchrony and the time to peak systolic velocity, which is corrected for heart rate, did not enhance any new value over DSE for detecting ischemia.
authors.affiliation: Department of Cardiology, Atatürk University, Erzurum, Turkey.
authors.forename: Muhammed Hakan
authors.initials: MH
authors.lastname: Tas
authors.forename: Enbiya
authors.initials: E
authors.lastname: Aksakal
authors.forename: Yekta
authors.initials: Y
authors.lastname: Gurlertop
authors.forename: Ziya
authors.initials: Z
authors.lastname: Simsek
authors.forename: Fuat
authors.initials: F
authors.lastname: Gundogdu
authors.forename: Serdar
authors.initials: S
authors.lastname: Sevimli
authors.forename: Eftal Murat
authors.initials: EM
authors.lastname: Bakirci
authors.forename: Sule
authors.initials: S
authors.lastname: Karakelleoglu
keywords: Dobutamine stress echocardiography; Ischemia; Tissue Synchronisation Imaging