Strain-Rate Imaging During Dobutamine Stress Echocardiography Provides Objective Evidence of Inducible Ischemia

Abstract

Background-Interpretation of dobutamine stress echocardiography (DSE) is subjective and strongly dependent on the skills of the reader. Strain-rate imaging (SRI) by tissue Doppler may objectively analyze regional myocardial function. This study investigated SRI markers of stress-induced ischemia and analyzed their applicability in a clinical setting. Methods and Results-DSE was performed in 44 patients with known or suspected coronary artery disease. Simultaneous perfusion scintigraphy served as a "gold standard" to define regional ischemia. All patients underwent coronary angiography. Segmental strain and strain rate were analyzed at all stress levels by measuring amplitude and timing of deformation and visual curved M-mode analysis. Results were compared with conventional stress echo reading. In nonischemic segments, peak systolic strain rate increased significantly with dobutamine stress (Ϫ1.6Ϯ0.6 s Ϫ1 versus Ϫ3.4Ϯ1.4 s

Detection of Diastolic Abnormality by Dyssynchrony Imaging Correlation With Coronary Artery Disease in Patients Presenting With Visibly Normal Wall Motion

“…11 Furthermore, increased amplitude of PSS during dobutamine stress echocardiography detected the presence of CAD using tissue Doppler strain rate imaging. 30 Those earlier observations are in accordance with our findings that a diastolic abnormality detected at rest by DADI has significant correlation with the presence of CAD in patients presenting with visibly normal LV wall motion. On the other hand, PSS does occur in approximately one-third of the normal population.…”

Longitudinal strain of right ventricular free wall by 2-dimensional speckle-tracking echocardiography is useful for detecting pulmonary hypertension

“…(Okuda et al , 2006, Pislaru et al , 2001, Voigt et al , 2003 Asanuma et al demonstrated use a canine model of coronary occlusion/reperfusion and showed that PSI significantly increased in the risk area until about 10 -20 min after coronary artery reperfusion, whereas PSS decreased in the risk area during occlusion but recovered to the baseline immediately after reperfusion. (Asanuma et al , 2012) Hosokawa et al demonstrated clinically that post-systolic shortening is a marker of recovery in patients with reperfused anterior myocardial infarction.…”

Transthoracic ultrasonic tissue indices identify patients with severe left anterior descending artery stenosis. Correlation with fractional flow reserve. Pilot study

“…Ultrasonic strain and strain rate can help to overcome the subjectivity of the method [9,10]. In the recent years, these techniques have been extensively used to differentiate clinically significant coronary stenosis [11][12][13]. Ultrasonic strain and strain rate are, in theory, independent of the overall heart motion and can be reliably used to measure regional myocardial deformation and deformation rate [10,14].…”