title: Temporal analysis of regional strain rate during adenosine triphosphate stress before and after percutaneous coronary interventions.
abstract: Regional myocardial ischemia is thought to be characterized by diastolic dysfunction. We aimed to clarify whether temporal analysis of strain rate (SR) index derived from two-dimensional speckle-tracking echocardiography (2DTE) can assess the regional myocardial ischemia or not. Forty-two patients with significant coronary stenoses were referred for percutaneous coronary intervention (PCI). 2DTE was performed before and a day after PCI. Time from aortic valve closure to peak early diastolic longitudinal SR ∆(TAVC-E SR) was measured both at baseline and during adenosine triphosphate (ATP) infusion. TAVC-E SR was calculated as TAVC-E SR during ATP infusion subtracted by TAVC-E SR at baseline. In forty-five target ischemic regions, TAVC-E SR at baseline was significantly longer than that of control regions (166 ± 28 vs. 136 ± 32 ms, P < 0.0001). TAVC-E SR in target ischemic regions significantly prolonged during ATP stress to 221 ± 37 ms (P < 0.0001), while it did not change in control regions. Immediately after PCI, TAVC-E SR in target regions significantly decreased to 135 ± 27 ms, P < 0.0001 without prolongation during ATP stress. Receiver operating characteristic curves demonstrated that ∆TAVC-E SR could assess regional myocardial ischemia by a cutoff criterion of 14 ms with sensitivity of 93% and specificity of 95%. 2DTE-derived TAVC-E SR significantly increased during ATP stress only in ischemic myocardium. This phenomenon disappeared immediately after PCI. Temporal analysis of TAVC-E SR appeared to be useful to assess the regional myocardial ischemia.
authors.affiliation: Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
authors.forename: Kazue
authors.initials: K
authors.lastname: Gunji
authors.forename: Atsushi
authors.initials: A
authors.lastname: Takagi
authors.forename: Kotaro
authors.initials: K
authors.lastname: Arai
authors.forename: Kyomi
authors.initials: K
authors.lastname: Ashihara
authors.forename: Nobuhisa
authors.initials: N
authors.lastname: Hagiwara
mesh_terms: D000255:Adenosine Triphosphate / Q000008:administration & dosage*; D000368:Aged; D019540:Area Under Curve; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D003971:Diastole; D015150:Echocardiography, Doppler; D025401:Echocardiography, Stress; D005260:Female; D006801:Humans; D007263:Infusions, Parenteral; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D011237:Predictive Value of Tests; D012372:ROC Curve; D012720:Severity of Illness Index; D013318:Stroke Volume; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left
chemical_list: D000255:Adenosine Triphosphate