Layer-specific analysis of dobutamine stress echocardiography for the evaluation of coronary artery disease

Park, Jae Hun; Woo, Jong Shin; Ju, Shin; Jung, Su Woong; Lee, In-Soo; Kim, Jin Bae; Kim, Soo–Joong; Kim, Weon; Kim, Woo-Shik; Kim, Kwon Sam

doi:10.1097/md.0000000000004549

Cited by 17 publications

(16 citation statements)

References 27 publications

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“…Rumbinaitė et al 11 found that longitudinal strain had the best predictive value for significant coronary artery stenosis (sensitivity = 89.4%, specificity = 64.7%). Park et al 12 found that GLPSS at stress has 85% sensitivity, 92% specificity, 80% PPV and 94% NPV in predicting significant CAD. In contrast, DSE was found to have 48% sensitivity, 83% specificity, 52% PPV and 81% NPV.…”

Section: Discussionmentioning

confidence: 99%

The predictive value of speckle tracking during dobutamine stress echocardiography in patients with chronic stable angina

Farag

Elrabbat

Mostafa

et al. 2020

Indian Heart Journal

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Objective Evaluation of the diagnostic value of speckle tracking echocardiography (STE) at rest and during dobutamine stress in predicting the presence and severity of coronary artery disease (CAD) in patients with chronic stable angina. Methods A total of 100 patients with chronic stable angina were evaluated using STE at rest and during dobutamine stress to detect the presence, severity, and number of affected coronary arteries. Then, the correlation with the SYNTAX score (SS) was analyzed. Results STE at stress showed better agreement with coronary angiography (CA) than dobutamine stress echocardiography (DSE) in detecting the presence of coronary artery stenosis (Kappa = 0.819, p < 0.001). STE at stress suggested involvement of the left anterior descending artery (LAD) with excellent agreement with CA (Kappa = 0.816, p < 0.001). For right coronary artery, STE at rest and stress showed good agreement with the CA results (Kappa = 0.775 and 0.858, respectively, p < 0.001), whereas for left circumflex artery, STE at rest and stress showed a fair agreement with the CA results (Kappa = 0.556 and 0.583, respectively, p < 0.001). Resting global longitudinal peak systolic strain (GLPSS) ≥ −15.2% had the best diagnostic accuracy (sensitivity = 61.8%; specificity = 93.5%) in predicting SS > 22. Stress GLPSS ≥ −12.5% had the best diagnostic accuracy (sensitivity = 82.4%; specificity = 78.3%) in predicting SS > 22. Conclusion Speckle tracking during DSE has high sensitivity and specificity for predicting the presence of CAD. It provides quantitative diagnostic information that decreases the false positive and false negative results of DSE.

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Section: Discussionmentioning

confidence: 99%

The predictive value of speckle tracking during dobutamine stress echocardiography in patients with chronic stable angina

Farag

Elrabbat

Mostafa

et al. 2020

Indian Heart Journal

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“…But recently LS2D-STE was used to predict the severity of coronary lesions. [40,41] To the best of our knowledge, this study is the first to predict VM using layer-specific strain and strain rate measured by LS2D-STE in patients with AMI. Our study showed that:…”

Section: Discussionmentioning

confidence: 99%

Evaluation of myocardial viability in patients with acute myocardial infarction

et al. 2019

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Background:The value of layer-specific two-dimensional speckle tracking echocardiography (LS2D-STE) for evaluating viable myocardium (VM) in patients with acute myocardial infarction (AMI) was unclear, this study provides new insights into it and to make a comparison with dualisotope simultaneous acquisition single photon emission computed tomography ( DISA-SPECT).Methods:Forty hospitalized patients with AMI and left ventricular systolic dysfunction (left ventricular ejection fraction <50%) underwent LS2D-STE and DISA-SPECT before percutaneous coronary intervention (PCI). The longitudinal, circumferential, and radial peak systolic strains and the peak systolic strain rates of 3 myocardiallayers (endocardium, mid-myocardium, and epicardium), as well as the total wall thickness, were determined by LS2D-STE. Routine echocardiography was followedup at 1, 3, 6 months after PCI, with the improvement of the wall motion as the goldenstandard for evaluating VM.Results:The sensitivity, specificity and accuracy of DISA-SPECT for evaluating VM were 82.1%, 74.3%, and 79.3%, respectively. Among the layer-specific parameters, only endocardial (endo-) longitudinal strain (LS) and endo- longitudinal strain rate (LSr) were used as independent parameters for evaluating VM (P < .05), and the sensitivity, specificity and accuracy of endo-LS and endo-LSr in evaluation of VM were 77.1%, 65.4%, and 72.9% vs 72.9%, 65.4%, and 69.7%. Endo-LS and endo-LSr were superior to total wall thickness LS and LSr (AUC endo-LS 0.767 vs total-LS 0.669; endo-LSr 0.743 vs total-LSr 0.682). The parallel test and the serial test of combination of endo-LS and endo-LSr showed similar sensitivity, specificity and accuracy to DISA-SPECT (P > .05).Conclusion:The endo-LS and endo-LSr analysis of LS2D-STE can evaluate the VM well, and its sensitivity, specificity and accuracy in detection of VM are similar to those of DISA-SPECT, resulting in LS2D-STE being a good option for the assessment of VM.

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“…to monitor cardiotoxicity in chemotherapy patients 9 , it is still mostly used for research purposes. Recently, clinical scientists increasingly utilize STE during functional assessments such as dobutamine stress echocardiography 19 or ergometer stress testing in adult 20 and pediatric patient populations 21 . However, the reproducibility of these combinatory assessments is still largely unknown, and data is scarce or incomplete in children 22 .…”

Section: Discussionmentioning

confidence: 99%

Speckle tracking stress echocardiography in children: interobserver and intraobserver reproducibility and the impact of echocardiographic image quality

Wilke

Schneyder

Roskopf

et al. 2018

Sci Rep

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Speckle tracking echocardiography (STE) is increasingly used during functional assessments. However, reproducibility and dependence on echocardiographic image quality for speckle tracking stress echocardiography in pediatric patients have not been studied to date. 127 consecutive normotensive children without structural heart disease (mean age 13.4 ± 3.0 years, 50.4% female) underwent a stepwise semisupine cycle ergometric protocol. Left ventricular (LV) myocardial peak strain and strain rate were assessed at rest and during exercise. Interobserver and intraobserver assessments were performed and analyzed regarding echocardiographic image quality. LV peak global strain and strain rate were well reproducible with narrow limits of agreement without any significant bias both at rest and during all stages of exercise testing. Moreover, strain rate reproducibility slightly deteriorated in values between −1.5 and −3 s−1. Surprisingly, there was no significant difference in reproducibility between optimal, intermediate and poor quality of echocardiographic images. STE derived strain and strain rate measurements in children are feasible and highly reproducible during semisupine cycle ergometric stress echocardiography. Echocardiographic image quality does not seem to influence strain (rate) reproducibility. Myocardial deformation measurements in images with suboptimal visualization quality must be interpreted with caution.

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Layer-specific analysis of dobutamine stress echocardiography for the evaluation of coronary artery disease

Abstract: Supplemental Digital Content is available in the text

Cited by 17 publications

References 27 publications

The predictive value of speckle tracking during dobutamine stress echocardiography in patients with chronic stable angina

The predictive value of speckle tracking during dobutamine stress echocardiography in patients with chronic stable angina

Evaluation of myocardial viability in patients with acute myocardial infarction

Speckle tracking stress echocardiography in children: interobserver and intraobserver reproducibility and the impact of echocardiographic image quality

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