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| Format: | Artículo científico |
| Langue: | en |
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Sociedad Argentina de Cardiología
2016
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| Accès en ligne: | https://www.redalyc.org/articulo.oa?id=305347333009 |
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Table des matières:
- Feasibility of Triple Imaging Vasodilator Stress Echo in Patients with Suspected Coronary Artery Disease Quirino Ciampi Marco Paterni Bruno Villari Eugenio Picano Medicina Stress Dipyridamole Echocardiography Blood Flow Velocity Myocardial Contraction Background: Regional wall motion abnormalities (RWMA) are the diagnostic cornerstone of stress echo, but the positivity rate has been declining over the last decades. Additional information is obtained with simultaneous assessment of coronary flow velocity reserve (CFVR) on left anterior descending coronary artery and global left ventricular contractile reserve (LVCR) from the systolic pressure/end-systolic volume relationship. Objective: The aim of this study was to assess the feasibility of triple imaging (RWMA + LVCR + CFVR) during dipyridamole stress echo. Methods: We enrolled 40 consecutive patients (30 men; 62±11 years, mean ejection fraction: 62±7%) referred to testing for sus- pected coronary artery disease. All patients underwent dipyridamole (0.84 mg/kg in 6 min) stress echo. LVCR was defined as the ratio between peak and rest elastance index (cuff systolic blood pressure/left ventricular end-systolic volume from biplane Simpson method, normal values: > 1.0). CFVR was defined as the ratio between maximal vasodilation and rest peak diastolic flow velocity in the left anterior descending coronary artery (normal values >2.0). Results: In 40 consecutive patients, interpretable images were obtained in 40/40 patients (100%) for RWMA, 40/40 (100%) for LVCR and 40/40 (100%) for CFVR. The positivity rate was 1/40 (2%) for RWMA, 4/40 (10%) for LVCR, 6/40 (15%) for CFVR and 9/40 (22.5%) with any of the three criteria combined. The average additional imaging time at peak stress after completion of RWMA im- aging was 45 seconds for CFVR; no extra-time was required for LVCR. The average off-line analysis time was 30 seconds for RWMA, 55 seconds for LVCR, and 15 seconds for CFVR. Conclusions: Triple imaging vasodilator stress echo was highly feasible and non-time consuming. Abnormal values are more fre- quently found with CFVR and LVCR than with RWMA. Triple imaging might become the new diagnostic standard in stress echo, and a larger scale validation is now ongoing in the Italian Stress echo 2020 multicenter study. 2016 artículo científico 0034-7000 https://www.redalyc.org/articulo.oa?id=305347333009 en http://www.redalyc.org/revista.oa?id=3053 Revista Argentina de Cardiología application/pdf Sociedad Argentina de Cardiología Revista Argentina de Cardiología (Argentina) Num.4 Vol.84