Quantitative evaluation of ischemic myocardium by adenosine tissue Doppler stress echocardiography
10.3321/j.issn:0253-3758.2008.10.011
- VernacularTitle:组织多普勒腺苷负荷超声心动图定量评估心肌缺血的应用
- Author:
Yin-Guang SUN
1
;
Qin-Hua ZHAO
;
Ru-Min HE
;
Wei-Feng SHEN
Author Information
1. 百汇医疗集团
- Keywords:
Coronary disease;
Echocardiography,stress;
Adenosine;
Doppler ultrasound
- From:
Chinese Journal of Cardiology
2008;36(10):907-911
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the value of adenosine tissue Doppler stress eehoeardiography on ischemic myocardium.Methods Routine dosage (140 μg· kg-1 · min-1 IV for 6 min) adenosine stress echocardiography was performed on 40 patients with chest pain for diagnosis of coronary artery disease (CAD).The images of left ventricular myocardial motion were acquired by tissue Doppler imaging (TDI)based on traditional 2D stress ochocardiography before and 3 min,6 rain after adenosine stress (GE Vivid 7,USA).The myocardial velocity,strain and strain rate in 16 segments were offline measured and analyzed on ECHOPAC software.The results were compared with that of coronary angiography (CAG).Results CAG identified 18 CAD and 22 non-CAD patients with 159 ischemie segments and 465 non-ischemic segments.Adenosine significantly increased the systolic velocity (Sm),early diastolic velocity (Em),late diastolic velocity (Am),peak systolic strain (Smax),systolic strain rate (SRs),early diastolic strain rate (SRe)and late diastolic strain rate (SRa) both iachemic and non-ischemic segments (all P＜0.05).The baseline Sm and Em in isehemic segments were significant lower than non-ischemic segments [(3.16±1.20) cm/svs (4.03+1.27) cm/s,P＜0.01;(3.75±1.67) cm/s vs (4.66±1.70) orals,P＜0.05].At peak stress the differences in Sm and Em were mere significant [(3.98±1.63) cm/s vs (5.07±1.52) cm/s;(4.51±2.32) cm/s vs (6.52±2.56) cm/s;P＜0.01].The reductions on Smax and Se were more significant in isehemic segments compared those in non-isehemic segments (16.91% ±3.35% vs 19.56%±5.47%,P＜0.01 and 9.53%±2.89% vs 13.06% ±4.63%,P＜0.001).The biggest area under curve (AUG) in peak stress was seen in Se by ROC curve analysis (AUG=0.740,with sensitivity 67%and specificity 83%).Conclusion Parameters derived from TDI offer reliable and accurate information on ischemic myocardium during adenosine stress echocardiography.
