Stress echocardiography 95whereas it increased significantly in patients with ischemia. Values obtained during standing exercise by treadmill or upright bicycle might differ from published cut-off normality values obtained during supine bicycle exercise. 3) LS recovers during postexercise (<2 min), as heart rate drops, paralleling LVEF changes. 4) Post-systolic LS is very specific for ischemic CAD, although sensitivity is low.
P556 | BEDSIDELeft ventricular 4D Strain during dobutamine stress echocardiography for diagnosis of coronary artery stenosis in patients with intermediate pretest probability of coronary artery disease E. Pavlyukova, N. Gladkikh, R. Karpov. Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Ischemic Heart Disease department, Tomsk, Russian Federation Introduction: Wall motion abnormalities and left ventricular (LV) ejection fraction (EF) are common parameters for ischemia diagnosis during stress echocardiography. Variability of these parameters is big. LV 4D Strain gives an opportunity to assess myocardial contractility objectively. Purpose: The aim of the study was to investigate sensitivity, specificity and diagnostic accuracy of LV 4D Global Longitudinal Strain (GLSLV), Global Circumferential Strain (GCSLV), Global Radial Strain (GRSLV) and Global Area Strain (GASLV) during dobutamine stress-echocardiography in patients with intermediate pretest probability of coronary artery disease (CAD). Methods: Fifty nine patients (mean age 55.81±6.97 years) with intermediate pretest probability of CAD (46.56±30.76%) and eleven healthy volunteers (mean age 45.55±10.11 years) were enrolled into the study. Significant (50% and more) stenosis of coronary artery (50% and more) was revealed in 32 (54.24%) patients. Standard stress echocardiography parameters and LV 4D Strain were assessed at rest and during peak dobutamine stress echocardiography. Results: LV 4D Strain did not change in healthy volunteers at peak stress. In patients with coronary artery stenosis of 50% and more GLSLV, GCSLV, GRSLV, GASLV decreased at peak dobutamine stress echocardiography (Clinical case in Fig. 1). In case of coronary artery stenosis <50% GCSLV, GRSLV and GASLV decreased, but no significant dynamics of GLSLV was found. Sensitivity, specificity and diagnostic accuracy of LV 4D Strain for diagnosis of coronary artery stenosis >50% are presented in Table 1. Conclusions: Global LV 4D Strain, including GLSLV, GCSLV, GRSLV, GASLV, decreases during peak dobutamine stress echocardiography in patients with coronary artery stenosis >50%. LV 4D Strain (GLSLV, GCSLV, GRSLV, GASLV) assessment during dobutamine stress echocardiography has low sensitivity, specificity and diagnostic accuracy for diagnosis of coronary artery stenosis >50% in patients with intermediate pretest probability of CAD. Objectives: Whether the patients of severe aortic valve insufficiency with significantly reduced left ventricular (LV) systolic function will benefit from surgery or not remains controversi...