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Premium Comparison of Quantitative Wall‐Motion Analysis and Strain for Detection of Coronary Stenosis with Three‐Dimensional Dobutamine Stress Echocardiography
Author(s)
Parker Katherine M.,
Clark Alexander P.,
Goodman Norman C.,
Glover David K.,
Holmes Jeffrey W.
Publication year2015
Publication title
echocardiography
Resource typeJournals
PublisherWiley
Background Quantitative analysis of wall motion from three‐dimensional (3D) dobutamine stress echocardiography ( DSE ) could provide additional diagnostic information not available from qualitative analysis. In this study, we compare the effectiveness of 3D fractional shortening (3 DFS ), a measure of wall motion computed from 3D echocardiography (3 DE ), to strain and strain rate measured with sonomicrometry for detecting critical stenoses during DSE . Methods Eleven open‐chest dogs underwent DSE both with and without a critical stenosis. 3 DFS was measured from 3 DE images acquired at peak stress. 3 DFS was normalized by subtracting average 3 DFS during control peak stress (∆3 DFS ). Strains in the perfusion defect ( PD ) were measured from sonomicrometry, and PD size and location were measured with microspheres. Results A ∆3 DFS abnormality indicated the presence of a critical stenosis with high sensitivity and specificity (88% and 100%, respectively), and ∆3 DFS abnormality size correlated with PD size (R 2  = 0.54). The sensitivity and specificity for ∆3 DFS were similar to that for area strain (88%, 100%) and circumferential strain and strain rate (88%, 92% and 88%, 86%, respectively), while longitudinal strain and strain rate were less specific. ∆3 DFS correlated significantly with both coronary flow reserve (R 2  = 0.71) and PD size (R 2  = 0.97), while area strain correlated with PD size only (R 2  = 0.67), and other measures were not significantly correlated with flow reserve or PD size. Conclusion Quantitative wall‐motion analysis using ∆3 DFS is effective for detecting critical stenoses during DSE , performing similar to 3D strain, and provides potentially useful information on the size and location of a perfusion defect.
Subject(s)cardiology , coronary artery disease , dobutamine , hemodynamics , materials science , medicine , metallurgy , nuclear medicine , perfusion , radiology , sonomicrometry , stenosis , strain (injury) , strain rate , stress echocardiography
Language(s)English
SCImago Journal Rank0.404
H-Index62
eISSN1540-8175
pISSN0742-2822
DOI10.1111/echo.12636

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