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Assessment of global left ventricular excursion using three‐dimensional dobutamine stress echocardiography to identify significant coronary artery disease
Author(s) -
Hoogslag Georgette E.,
Joyce Emer,
Bax Jeroen J.,
Ajmone Marsan Nina,
Delgado Victoria
Publication year - 2016
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.13285
Subject(s) - medicine , coronary artery disease , cardiology , excursion , dobutamine , stenosis , coronary angiography , angiography , confidence interval , myocardial infarction , hemodynamics , political science , law
Background Quantitative three‐dimensional (3D) dobutamine stress echocardiography ( DSE ) for myocardial ischemia detection may be an adjuvant to left ventricular ( LV ) wall‐motion analysis. The aim of the current study was to assess the association between global 3D LV excursion during DSE and the presence of significant coronary artery disease ( CAD ) on coronary angiography. Methods Three‐dimensional DSE was performed in 40 patients (67±12 years, 68% male) who underwent subsequent coronary angiography (median 1.6 months later). Using 3D echocardiography, global LV excursion was measured (in a total of 680 segments) at rest and peak dose and the change between stages was calculated (peak‐rest=∆global LV excursion). Significant CAD was defined as >70% stenosis on coronary angiography. Results In total, 25 patients (63%) demonstrated significant CAD on coronary angiography. At rest, global LV excursion was similar in patients with and without significant CAD (5.1±0.2 vs 5.0±0.2 mm, P =.74). However, patients with significant CAD demonstrated a worsening in global LV excursion from rest to peak stress (from 5.1±0.2 to 4.1±0.2 mm, P <.001), while global LV excursion in patients without significant CAD remained unchanged (from 5.0±0.2 to 5.5±0.2 mm, P =.10). After adjusting for clinically relevant characteristics, ∆global LV excursion was independently associated with significant CAD (odds ratio 0.29, 95% confidence interval 0.12–0.72, P =.008). Conclusions Analysis of 3D echocardiographic LV excursion at global level on full‐protocol DSE may be a helpful tool to detect CAD on coronary angiography.