European Journal of Echocardiography Advance Access originally published online on February 7, 2009
European Journal of Echocardiography 2009 10(5):607-612; doi:10.1093/ejechocard/jep011
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Quantification of low-dose dobutamine stress using speckle tracking echocardiography in coronary artery disease
1 Vivus-BMJ Heart Center, Bangalore, India
2 Saint Francis Hospital, New York, USA
3 Karolinska Institute at the Department of Clinical Physiology, Karolinska University Hospital at Huddinge, Stockholm, Sweden
4 Royal Institute of Technology, Stockholm, Sweden
5 University of Crete, Greece
6 Department of Clinical Physiology, Sundsvalls Regional Hospital, 85186 Sundsvall, Sweden
Received 18 November 2008; accepted after revision 17 January 2009; online publish-ahead-of-print 7 February 2009.
* Corresponding author. Tel: +46 60 18 12 51; fax: +46 60 18 22 20. E-mail address: samir.saha{at}ki.se, samirksaha{at}gmail.com
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Abstract |
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Aims: We sought to evaluate the utility of speckle tracking echocardiography (STE) for detecting left ventricular (LV) mechanical abnormalities during low-dose (20 µg) dobutamine stress (DSE).
Methods and results: Twenty-nine patients (56 ± 12 years) with a history of recent acute coronary events (ACE) underwent STE-DSE. Left ventricular images, sampled at frame rates 70–100 Hz, were analysed off-line (Echopac BT 6.0.0). Velocity, strain, and rotational imaging were performed. Twenty patients had LV ejection fraction (EF) >40% (Group 1) whereas nine patients had LVEF <40% (Group 2). Average heart and frame rates were identical during DSE in the two groups (P = ns). Global circumferential strain (%) was significantly lower in Group 2 compared with Group 1 (10.65 ± 5.30 vs. 16.82 ± 6.61; P < 0.05) at rest and during peak stress (14.72 ± 6.51 vs. 21.13 ± 7.2; P < 0.05). The global peak rotation rate (degree/s) was, however, higher at rest in Group 2 (70 ± 97 vs. 19 ± 67; P < 0.05) and 20 µg stress. Peak systolic velocity increased in three of the four LV walls at 20 µg (in Groups 1 and 2). A global rotational rate increased significantly at 20 µg during systole in both the groups, but was unchanged in Group 2 during diastole.
Conclusions: Speckle tracking echocardiography dobutamine stress appears to provide comprehensive information on LV mechanical status in the aftermath of ACE. The modality may help risk stratify such patients.
Keywords: Speckle tracking echocardiography; 2D strain; Coronary artery disease; Left ventricular function; Dobutamine stress echocardiography