Use of tissue Doppler imaging to facilitate the prediction of events in patients with abnormal left ventricular function by dobutamine echocardiography
Section snippets
Patient selection
Of 576 patients who underwent dobutamine echocardiography (DE) over a 16-month period from September 1998 to January 2000, 251 had abnormal DE as assessed by wall motion score (WMS). The clinical characteristics of these patients are listed in Table 1.
Dobutamine echocardiography
A standard dobutamine-atropine stress protocol was performed, using a starting dose of 5 μg/kg/min, and increasing the dosage every 3 minutes to 10, 20, 30, and 40 μg/kg/min.4 Atropine was given (to a maximum of 1 mg) if 85% of age-predicted
Dobutamine echocardiography
The dobutamine stress test was terminated due to side effects in 43 patients (17%). The most common side effects were hypertension (4%), hypotension (3%), and nonsustained ventricular tachycardia (1%). Angina pectoris occurred in 73 patients (29%), and electrocardiographic changes of ischemia were present in 75 patients (30%).
All patients had an abnormal dobutamine echocardiogram. Wall motion abnormalities at rest were present in 60%, 27% of whom showed augmentation at low-dose dobutamine The
Discussion
The results of this study indicate that the measurement of peak systolic velocity in the basal segments at peak dobutamine stress is a powerful predictor of adverse events in follow-up. Although myocardial displacement also showed valuable prognostic information, peak velocity is the simplest and most robust tool. Moreover, over a 2-year follow-up, the average velocity parameters were better predictors of adverse outcome than the WMS.
In patients with stable chronic coronary disease, the finding
References (24)
- et al.
Effect of tissue Doppler on the accuracy of novice and expert interpreters of dobutamine echocardiography
Am J Cardiol
(2001) - et al.
Objective evaluation of regional left ventricular wall motion during dobutamine stress echocardiographic studies using segmental analysis of color kinesis images
J Am Coll Cardiol
(1999) - et al.
Methodology, feasibility, safety and diagnostic accuracy of dobutamine stress echocardiography
J Am Coll Cardiol
(1997) - et al.
Enhanced sensitivity for detection of coronary artery disease by addition of atropine to dobutamine stress echocardiography
Am J Cardiol
(1992) - et al.
Stress echocardiographyrecommendations for performance and interpretation of stress echocardiography. Stress Echocardiography Task Force of the Nomenclature and Standards Committee of the American Society of Echocardiography
J Am Soc Echocardiogr
(1998) - et al.
Application of tissue Doppler to interpretation of dobutamine echocardiographycomparison with quantitative coronary angiography
Am J Cardiol
(2001) - et al.
Automated regional myocardial displacement for facilitating the interpretation of dobutamine echocardiography
Am J Cardiol
(2002) - et al.
Task force 5. Stratification of patients into high, medium and low risk subgroups for purposes of risk factor management
J Am Coll Cardiol
(1996) - et al.
Independent and incremental prognostic value of exercise single-photon emission computed tomographic (SPECT) thallium imaging in coronary artery disease
J Am Coll Cardiol
(1993) - et al.
Incremental value of prognostic testing in patients with known or suspected ischemic heart diseasea basis for optimal utilization of exercise technetium-99m sestamibi myocardial perfusion single-photon emission computed tomography
J Am Coll Cardiol
(1995)
Left ventricular volume changes during dobutamine stress echocardiography identify patients with more extensive coronary artery disease
J Am Coll Cardiol
Left ventricular wall motion score as an early predictor of left ventricular dilation and mortality after first anterior infarction treated with thrombolysis
Am J Cardiol
Cited by (45)
Tissue doppler imaging in echocardiography: Value and limitations
2015, Heart Lung and CirculationCitation Excerpt :Colour tissue Doppler imaging a’ velocity permits evaluation of segmental atrial function [43]. s’ velocity has been investigated in a variety of cardiac conditions, including heart failure, cardiomyopathies, valvular as well as coronary artery disease [9,23,28,35], for both diagnosis as well as for long-term prognosis. It is also useful to identify patients with cardiac dyssynchrony [7].
Improved tracking performance of lagrangian block-matching methodologies using block expansion in the time domain: In silico, phantom and invivo evaluations
2014, Ultrasound in Medicine and BiologyEchocardiography and Vascular Ultrasound: New Developments and Future Directions
2013, Canadian Journal of CardiologyCitation Excerpt :Exercise or pharmacological stress echocardiography identifies viable myocardium by detecting the presence of contractile reserve. Wall motion analysis for viability can be supplemented by TDI and strain analysis.28,30 The use of TDI for the assessment of viability is somewhat more limited than strain imaging, because of the lack of site specificity.
Use of Tissue Doppler During Dobutamine Stress Echocardiography
2010, Dynamic EchocardiographyIntroduction of tissue Doppler imaging echocardiography - Based on pulsed-wave mode
2008, Journal of Medical Ultrasound