Dobutamine-stress echocardiography speckle-tracking imaging in the assessment of hemodynamic significance of coronary artery stenosis in patients with moderate and high probability of coronary artery disease

Rumbinaitė, Egle; Žaliaduonytė-Pekšienė, Diana; Vieželis, Mindaugas; Čeponienė, Indrė; Lapinskas, Tomas; Žvirblytė, Rūta; Venclovienė, Jonė; Morkūnaitė, Kristina; Bielinis, Augustinas; Šlapikas, Rimvydas; Vaškelytė, Jolanta Justina

doi:10.1016/j.medici.2016.11.005

Cited by 20 publications

(25 citation statements)

References 26 publications

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“…Echocardiography [23] An echocardiography might be performed as a stress test under physical exercise or under concomitant administration of medication such as dipyridamole or dobutamine. This procedure might reveal areas in the left ventricle (LV) with wall abnormalities or hypocontractility.…”

Section: Procedures Explanationmentioning

confidence: 99%

Potential Beneficial Effects of Vitamin D in Coronary Artery Disease

et al. 2019

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Vitamin D plays a pivotal role in bone homeostasis and calcium metabolism. However, recent research has indicated additional beneficial effects of vitamin D on the cardiovascular system. This review aims to elucidate if vitamin D can be used as an add-on treatment in coronary artery disease (CAD). Large-scale epidemiological studies have found a significant inverse association between serum 25(OH)-vitamin D levels and the prevalence of essential hypertension. Likewise, epidemiological data have suggested plasma levels of vitamin D to be inversely correlated to cardiac injury after acute myocardial infarction (MI). Remarkably, in vitro trials have showed that vitamin D can actively suppress the intracellular NF-κB pathway to decrease CAD progression. This is suggested as a mechanistic link to explain how vitamin D may decrease vascular inflammation and atherosclerosis. A review of randomized controlled trials with vitamin D supplementation showed ambiguous results. This may partly be explained by heterogeneous study groups. It is suggested that subgroups of diabetic patients may benefit more from vitamin D supplementation. Moreover, some studies have indicated that calcitriol rather than cholecalciferol exerts more potent beneficial effects on atherosclerosis and CAD. Therefore, further studies are required to clarify these assumptions.

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Section: Procedures Explanationmentioning

confidence: 99%

Potential Beneficial Effects of Vitamin D in Coronary Artery Disease

et al. 2019

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“…Since Voight et al, [ 37 ] demonstrated that strain rate analysis during SE provides objective evidence of ischemia, the interest of using quantitative assessment of LV systolic function by 2D speckle tracking during SE gained interest because it removes the subjective nature of visual assessment by wall motion analysis (WMA) in detecting CAD. Hence, a number of studies have shown that imaging GLS% was as good as [ 38 ], [ 39 ] or even superior [ 37 ], [ 40 ] [ 41 ] to conventional echocardiography, subsequently lot of them concluding that GLS% provides incremental diagnostic accuracy in combination with expert WMA [ 42 ] in detecting CAD. Our results were partly in line with such conclusions; however only WMSI appeared as independent predictor of CAD which was consistent with the results of dobutamine SE study of Celutkiene et al, [ 43 ] who stressed that none of the single quantitative parameters investigated was able to identify significant CAD with a comparable diagnostic accuracy vs visual assessment using WMA.…”

Section: Discussionmentioning

confidence: 99%

Does the Presence of Diabetes Mellitus Make a Difference in Pharmacological Stress Echocardiography Outcome Results?

Andova¹,

Georgievska-Ismail²,

Srbinovska³

et al. 2018

Open Access Maced J Med Sci

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BACKGROUND:Coronary artery disease (CAD) is the leading cause of mortality and morbidity in patients with diabetes (DM).AIM:The aim of our study was to analyse the ability of pharmacological SE to risk stratify patients with DM using qualitative and quantitative assessment of LV function.METHODS:We prospectively assessed 105 consecutive patients (58.7 ± 9.5 y, 39 male) with known or suspected CAD who underwent dipyridamole or dobutamine SE.RESULTS:Change of systolic LV function at maximal SE was less pronounced in patients with DM, while parameters of the diastolic function and its change with stress were almost insignificant. WMSI in comparison to GLS% didn’t make a difference in SE outcome regarding DM presence. WMSI was almost unchanged at maximal stress in diabetic patients. Conversely, GLS% showed significant worsening at maximal stress in diabetic patients. However, only WMSI at maximal stress along with DM presence appeared as independent predictors of the presence of new and worsening CAD during SE. Longitudinal strain assessed using speckle tracking during pharmacological stress echocardiography was superior to conventional echocardiography expressed by wall motion analysis in making a difference regarding DM presence.CONCLUSION:We confirmed the usefulness of stress echocardiography using qualitative and/or quantitative parameters in the detection of CAD in patients with DM.

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“…Some studies determined the diagnostic value of speckle-tracking echocardiography in derived myocardial deformation parameters at rest and during stress, can evaluate hemodynamically signifi cance in coronary artery stenosis on those patients with moderate and high probability of CAD. Also, it showed that left ventricular strain and strain rate analyses during DSE can be used in the assessment of hemodynamic signifi cance in coronary artery stenosis, with patients that have moderate and high risk for CAD, with good accuracy [27,28]. One the strategies proposed by Mathias et al [17], to improve DASE sensitivity was the rapid injection of metoprolol in the stress peak with acquisition of post-metoprolol images in maximum range of three minutes.…”

Section: Diagnostic Value and Prognosis Of Dobutamine-atropine Stressmentioning

confidence: 99%

Myocardial Contrast and Stress Echocardiography: New Frontiers

Dourado¹,

Tsutsui²,

Filho³

et al. 2017

Biomed Sci Eng

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Stress Echocardiography is an established technique used all over the world as a non invasive evaluation of patients with coronary artery disease (CAD) and also an important method to evaluate myocardial viability and the contractile reserve.Myocardial contrast echocardiography (MCE) is a well-defi ned technique to improve delineation of the endocardic borders. It has been increasingly used for the assessment of myocardial perfusion, due to the development of techniques which proportionate simultaneous analysis of myocardial perfusion and function in real-time, it also increases the sensitivity of stress testing for the detection of CAD and it distinguishes between stunned and infarcted myocardium after acute ischemia.The development of new techniques as strain, strain rate, speckle tracking, real time three dimensional, tissue Doppler, second harmonic image and the use of new contrast agents, associated with digital image development brings new lights about stress and contrast echocardiograph and expands its potential use to evaluate CAD. Coronary disease is the main cause of morbidity and mortality in the ocidental world and, according to World Health Organization, it will be the main cause of death throughout the world in the near future. Therefore, in this review, we present the actual level of development of these important techniques in the setting of the CAD.

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Dobutamine-stress echocardiography speckle-tracking imaging in the assessment of hemodynamic significance of coronary artery stenosis in patients with moderate and high probability of coronary artery disease

Abstract: Left ventricular strain and strain rate analyses during DSE can be used in the assessment of hemodynamic significance of coronary artery stenosis in patients with moderate and high risk for CAD.

Cited by 20 publications

References 26 publications

Potential Beneficial Effects of Vitamin D in Coronary Artery Disease

Potential Beneficial Effects of Vitamin D in Coronary Artery Disease

Does the Presence of Diabetes Mellitus Make a Difference in Pharmacological Stress Echocardiography Outcome Results?

Myocardial Contrast and Stress Echocardiography: New Frontiers

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