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European Journal of Echocardiography 2000 1(3):196-203; doi:10.1053/euje.2000.0033
© 2000 by European Society of Cardiology
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Copyright © 2000, The European Society of Cardiology

Changes in Left Ventricular Filling Pattern During Dobutamine Stress Doppler Echocardiography

V. Bodí1,*, J. Sanchis2, J. Cortés1, J.V. Monmeneu1, F. Marín1, E. Llobet1 and A. Llácer2

1Cardiology Unit, Marina Baixa Hospital, Partida Galandú 5, 03570, La Vila Joiosa, Spain
2Cardiology Department, Clinic Universitari Hospital, Avda. Blasco Ibáñez 17, 46010, València, Spain


  Abstract

Aims: To study the left ventricular filling pattern during stress Doppler echocardiography and its utility in the detection of myocardial ischaemia.

Methods and Results:Fifty-seven consecutive patients underwent dobutamine stress echocardiography. The left ventricular filling pattern (E-wave velocity; A-wave velocity; E/A ratio; E-wave deceleration time) was analysed at baseline and at maximum heart rate reached. The percentage increase in these parameters from baseline to peak heart rate was also determined. Myocardial ischaemia (regional contractility worsening) was induced in 19 cases (ischaemic group) but not in 38 cases (non-ischaemic group). There were no differences between both groups at baseline. E-wave deceleration time decreased in the non-ischaemic group (197±63 vs. 167±65 ms, P=0·01) and increased in the ischaemic group (203±42 vs. 315±135 ms, P<0·0001). A percentage increase in E-wave deceleration time of >30% showed a positive predictive value of 93% and a negative predictive value of 86% for detecting ischaemia, and in the multivariate analysis it was the only Doppler parameter (P<0·0001) that predicted the induction of ischaemia.

Conclusion: We conclude that myocardial ischaemia provokes an increase in E-wave deceleration time. Analysis of left ventricular filling could help in the identification of those cases which are positive for ischaemia.

Keywords: dobutamine stress echocardiography; Doppler; diastolic function; myocardial ischaemia

* Address for correspondence: V. Bodí, Cardiology Unit, Marina Baixa Hospital, Partida Galandú 5, 03570 La Vila Joiosa, Spain.


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