Diagnostic value of quantitative low-dose dobutamine stress echocardiography with three-dimensional speckle-tracking for non-ST-elevation acute coronary syndrome
10.3969/j.issn.1673-4254.2015.07.04
- VernacularTitle:三维斑点追踪结合多巴酚丁胺负荷超声诊断非ST段抬高性急性冠脉综合征的价值
- Author:
Junsong LIU
1
;
Yong XU
;
Jing WANG
;
Bo ZHANG
;
Bohan LIU
;
Wenqing LÜ
;
Guang ZHI
Author Information
1. 解放军总医院心血管内科
- Keywords:
three-dimensional speckle-tracking;
dobutamine stress test;
non-ST-elevation acute coronary syndrome;
strain;
echo-cardiography
- From:
Journal of Southern Medical University
2015;(7):947-953
- CountryChina
- Language:Chinese
-
Abstract:
s:Objective To access left ventricular global deformation abnormalities during low-dose dobutamine stress test (DSE) by three-dimensional speckle-tracking echocardiography (3D-STE)in patients with non-ST-elevation acute coronary syndrome (NSTE-ACS), and explore the diagnostic value of 3D-STE combined with DES for NSTE-ACS. Methods Forty-nine patients with suspected NSTE-ACS underwent DSE and coronary angiography with an initial dobutamine dose of 5μg·kg-1·min-1, which was doubled at 3-min intervals to the peak dose of 20 μg ·kg-1 ·min-1. The global longitudinal strain (GLS), global circumferential strain (GCS), territory longitudinal strain (TLS), and territory circumferential strain (TCS) of the left ventricular subendocardial myocardium were measured with 3D-STE at rest and at the peak-dose stage. Conventional echocardiography and 3D-STE parameters and their changes during DSE were evaluated, and their diagnostic values were analyzed according to the receiver-operating characteristic (ROC) curves. Results All the patients completed DSE uneventfully and 3D-STE showed a good reproducibility of the results. Compared with patients with non-NSTE-ACS, NSTE-ACS patients showed obviously reduced resting left ventricular global deformation function especially in terms of circumferential deformation (P<0.05);the ROC curves for the parameters were similar between the two groups (P>0.05). During DSE, the global deformation differences between the two groups further increased (P<0.01), and the diagnostic values of the peak-dose stage parameters were significantly greater than those of the resting parameters. ROC curves analysis showed that TLS and TCS at peak-dose stage had the highest diagnostic value for NSTE-ACS. Conclusion 3D-STE combined with low-dose DSE is a safe and effective noninvasive technique for accessing and identifying NSTE-ACS, and DSE can significantly enhance the diagnostic value of 3D-STE.
