ABSTRACT

Objective:

To evaluate the utility of dobutamine stress pulsed-wave tissue Dopp-ler echocardiography in differentiating ischemic myocardial segments from non-ischemic ones

Materials and Methods:

Eighteen patients (mean age 56.4±7.7, 11 male) who had normal left ventricular regional wall motion analysis at rest and undergoing coronary angiography for clinical reasons were included. In each subject, mitral annular, basal, and mid-segment systolic velocities was obtained from the apical echocardiographic windows at rest and during peak dobutamine infusion. Two systolic velocity measu-rements were used to calculate the percent increase in systolic velocity (S%) during peak dobutamine infusion relative to rest measurements. Coronary artery disease was defined as ≥50 percent stenosis in at least one major epicardial coronary ar-tery. The myocardial segments were classified into 3 groups. The cardiac segments belonging to patients with normal coronary angiograms were Group 1. The cardiac segments belonging to patients with coronary artery disease were classified as Gro-up 2 if the segment was supplied by a normal coronary artery or Group 3 if it was supplied by a stenosed artery.

Results:

S% values in Groups 1, 2, and 3 were 79.0±39.2, 76.1±25.3, and 49.2±23, respectively (F=19.175, p<0.001). S% values in Group 3 were lower than those in both Groups 1 and 2 (p<0.001). Based on ROC analysis, S% less than 59% predicts ischemic segments with a sensitivity of 75% and a specificity of 75%.

Conclusion

s:In patients who have normal left ventricular regional wall motion analysis S% obtained using dobutamine stress pulsed-wave tissue Doppler echocar-diography may be useful in differentiating ischemic segments from non-ischemic ones.