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European Journal of Echocardiography 2003 4(3):169-177; doi:10.1016/S1525-2167(02)00161-0
© 2003 by European Society of Cardiology
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Copyright © 2003, The European Society of Cardiology

Quantitative analysis of dobutamine–atropine stress echocardiography

S Carstensen*, U Høst, K Saunamäki and H Kelbæk

Department of Medicine B 2142, The Heart Centre at Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

Received 4 July 2002; accepted after revision 9 October 2002.

* Address correspondence to: Steen Carstensen, MD., Department of Medicine B 2142, The Heart Centre at Rigshospitalet, University of Copenhagen, Blegdamsvej 9, DK-2100 Copenhagen, Denmark. Tel: +45 354 52760; Fax: +45 354 52705. sc{at}dadlnet.dk


   Abstract

Aims: To investigate the usefulness of fractional area change of entire left ventricular areas obtained from apical views for quantitative analysis of dobutamine–atropine stress echocardiography in the presence of mild to moderately reduced left ventricular function and abnormal intra-thoracic heart motion after coronary artery bypass surgery.

Methods and Results: Stress echocardiograms from 38 echogenic patients before and 3 months after bypass surgery and from 44 echogenic healthy subjects were analysed. In successfully revascularized patients the fractional area change at peak stress was correlated to the baseline left ventricular ejection fraction (r=0.54, P<0.01), whereas the increase from baseline to peak stress was constant over a wide range of baseline ejection fractions. With respect to identifying the pre-revascularization examination as diseased, the area under the receiver operator characteristics curve based on {Delta} fractional area change from baseline to peak stress was 0.78 (95% CI 0.55–1.00) indicating moderate accuracy comparable with the results obtained with conventional analysis.

Conclusion: Fractional area change of entire left ventricular cavity areas is a useful parameter for quantitative analysis of dobutamine–atropine stress echocardiography. The diagnostic properties of the parameter are not offset by moderate reduction in left ventricular function or by surgery-induced abnormal intra-thoracic heart motion.

Keywords: drugs; echocardiography; ischaemia; stress


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