title: The value of assessing myocardial deformation at recovery after dobutamine stress echocardiography.
abstract: BACKGROUND
  The purpose of this study was to evaluate whether performing an assessment of myocardial deformation using speckle tracking imaging during the recovery period after dobutamine stress echocardiography (DSE) allows detection of significant coronary artery disease (CAD) in patients with chest discomfort.
  
  
  METHODS
  DSE and coronary angiography were performed in 44 patients with chest discomfort. The mean global longitudinal peak systolic strain (GLS) was measured at rest, at low stress (dobutamine infusion rate of 10 µg/kg/min) and at recovery (5 min after cessation of dobutamine infusion) of DSE using automated function imaging with apical views. Fractional flow reserve (FFR) was also performed in patients with intermediate coronary stenosis. CAD was defined as having a ≥ 70% diameter stenosis on coronary angiography or as having a FFR < 0.8. Patients were divided two groups based on the absence or presence of CAD [CAD (-) group vs. CAD (+) group].
  
  
  RESULTS
  There were no significant differences in the clinical characteristics and results of conventional echocardiography between the two groups. GLS at recovery was lower in the CAD (+) group than in the CAD (-) group (-18.0 ± 3.4% vs. -21.0 ± 1.9%, p = 0.003). The optimal cutoff of GLS at recovery for detection of CAD was -19% (sensitivity of 70.6%, specificity of 83.3%).
  
  
  CONCLUSIONS
  Assessment of GLS at recovery of DSE is a reliable and objective method for detection of CAD. This finding may suggest that systolic myocardial stunning remains even after recovery of wall motion abnormalities in patients with CAD.
authors.affiliation: Department of Cardiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Korea.
authors.forename: Hui-Jeong
authors.initials: HJ
authors.lastname: Hwang
authors.affiliation: Department of Cardiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Korea.
authors.forename: Hyae-Min
authors.initials: HM
authors.lastname: Lee
authors.affiliation: Department of Cardiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Korea.
authors.forename: In-Ho
authors.initials: IH
authors.lastname: Yang
authors.affiliation: Department of Cardiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Korea.
authors.forename: Jung Lok
authors.initials: JL
authors.lastname: Lee
authors.affiliation: Department of Cardiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Korea.
authors.forename: Hyun Young
authors.initials: HY
authors.lastname: Pak
authors.affiliation: Department of Cardiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Korea.
authors.forename: Chang-Bum
authors.initials: CB
authors.lastname: Park
authors.affiliation: Department of Cardiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Korea.
authors.forename: Eun-Sun
authors.initials: ES
authors.lastname: Jin
authors.affiliation: Department of Cardiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Korea.
authors.forename: Jin-Man
authors.initials: JM
authors.lastname: Cho
authors.affiliation: Department of Cardiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Korea.
authors.forename: Chong-Jin
authors.initials: CJ
authors.lastname: Kim
authors.affiliation: Department of Cardiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Korea.
authors.forename: Il Suk
authors.initials: IS
authors.lastname: Sohn
keywords: Dobutamine; Myocardial stunning; Speckle tracking imaging; Stress echocardiography