Objective: To explore the application value of real-time adenosine stress 3-dimensional echocardiography (3D-ASE) for diagnosing the patients with of coronary artery disease (CAD).
Methods: A total of 46 suspicious CAD patients were studied by 3D-ASE analysis. There were 26 male and 20 female patients from (38-73) years of age at the mean of (63.3 ± 7.2) years. Adenosine stress echocardiography was performed by infusing the agent at 140 ug/(kg?min) in 6 minutes. The changes of segmental ventricular wall motion, electrocardiogram (ECG), clinical symptoms, blood pressure and heart rate were recorded. Positive 3D-ASE result was deifned by the time of left ventricular segment minimum contraction volume gradually extending. Coronary angiograph (CAG) was conducted at 2 weeks after 3D-ASE, positive CAG ifnding was conifrmed by at least one of three main branches with the stenosis≥50%.
Results: There were 29/46 patients with positive CAG findings, 26 with positive 3D-ASE presentations and 8 with positive adenosines tress ECG. CAG showed that 48 coronary branches were positive and 90 were negative;3D-ASE indicated that 40 coronary branches were positive and 98 were negative. For 3D-ASE diagnosed coronary lesions, the overall sensitivity was 89.6%(26/29), speciifcity 76.5%(13/17), accuracy 84.8%(39/46). There were 36 branch lesions conifrmed by both CAG and 3D-ASE. For 3D-ASE determined coronary lesions, the sensitivity was 75%(36/48), speciifcity 95.6%(86/90), accuracy 88.4%(122/138). For 3D-ASE found single, double and three vessels diseases, the sensitivities were 60%(9/15), 88.9%(8/9) and 100%(5/5) respectively. The e occurrence rate of 3D-ASE side effect was 52.2%, there were usually slight symptoms without severe adverse reaction.
Conclusion: 3D-ASE has the high sensitivity and speciifcity in CAD diagnosis, it is an non-invasive examination with slight side effect, and therefore, has an important application value in clinical practice.