Jenkins, C and Haluska, B and Marwick, TH, Assessment of temporal heterogeneity and regional motion to identify wall motion abnormalities using treadmill exercise stress three-dimensional echocardiography, Journal of the American Society of Echocardiography, 22, (3) pp. 268-275. ISSN 0894-7317 (2009) [Refereed Article]
Copyright 2009 The American Society of Echocardiography
Methods Conventional 2DE and 3DE at rest and peak stress were performed in 110 patients (78 men, aged 60 ± 11 years) who underwent angiography within 6 months. Offline assessment of CFM was performed qualitatively (delayed regional relaxation in a coronary territory) and quantitatively (difference in regional and global contraction delays from rest to peak in individual segments). The accuracy of each test was calculated for identification of 70% or more diameter angiographic stenoses.
Results Patients were excluded for nondiagnostic stress (n = 12) or poor-quality 3DE (n = 8). Time until end of 2DE acquisition was 58 ± 25 seconds, and time until end of 3DE (taken after 2DE) was 109 ± 55 seconds. Receiver operating characteristic analyses were used to define normal cutoff ranges of contraction delays for the following coronary territories: left anterior descending (≤10%), left coronary artery (≤10%), right coronary artery (≤11%), and overall (≤10%). The concordance between angiography and qualitative CFM (63%) was similar to quantitative CFM (70%). The sensitivity of wall motion assessment at 3DE (40%) was lower than CFM (55%, P = .04) and 2DE (83%, P < .01) at comparable levels of specificity (65%, 84%, and 78%).
Conclusion Although the higher specificity of 3DE may represent avoidance of false-positives from off-axis imaging, the sensitivity of 3DE is insufficient for clinical use. Analysis of the temporal distribution of contraction may be more sensitive than 3D wall motion assessment for identification of ischemia at exercise 3DE.
|Item Type:||Refereed Article|
|Keywords:||contraction front mapping, Exercise stress echocardiography, Left ventricle, 2-dimensional echocardiography, 3-dimensional echocardiography|
|Research Division:||Medical and Health Sciences|
|Research Group:||Cardiorespiratory Medicine and Haematology|
|Research Field:||Cardiology (incl. Cardiovascular Diseases)|
|Objective Group:||Clinical Health (Organs, Diseases and Abnormal Conditions)|
|Objective Field:||Cardiovascular System and Diseases|
|Author:||Marwick, TH (Professor Tom Marwick)|
|Web of Science® Times Cited:||10|
|Deposited By:||Menzies Institute for Medical Research|
Repository Staff Only: item control page