Original articleIs quantitative interpretation likely to increase sensitivity of dobutamine stress echocardiography? A study of false-negative results☆
Section snippets
Patient population
We studied 48 patients (29 men; mean age 60 ± 10 years) who underwent color DTI and DSE to investigate chest pain or other symptoms suggestive of coronary artery disease (CAD), in whom the DSE was interpreted as normal despite a maximal stress, but who proceeded to coronary angiography within 6 months. Patients with left ventricular (LV) systolic dysfunction (ejection fraction < 50% or akinesis) at rest, a wall-motion abnormality during the DSE, or a submaximal stress test (ie, termination at
Patient characteristics
The clinical characteristics and echocardiographic parameters between patients with true- and false-negative results of DSE are summarized in Table 1. For patients with false-negative results of DSE, 4 were treated with β-blockers and 8 had single-vessel disease (left anterior descending artery disease in 4 and left circumflex artery disease in 4). Of those with single-vessel disease, 5 were classified into group 1 (2 in left anterior descending artery disease and 3 in left circumflex artery
Discussion
To our knowledge, this is the first study to show that the segments with false-negative results of DSE demonstrate no induced ischemia, rather then being overlooked by the interpreter. Further, the reduced wall stress has no influence on the parameters of regional contractility.
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Stress echocardiography
Dobutamine-atropine stress echocardiography for the detection of coronary artery disease in patients with left ventricular hypertrophyimportance of chamber size and systolic wall stress
Circulation
Cited by (13)
Assessment of Postsystolic Shortening and Global Longitudinal Strain Improves the Sensitivity of Dobutamine Stress Echocardiography in End-Stage Liver Disease
2023, Journal of the American Society of EchocardiographyThe significance of E/E' to detect coronary artery disease during dobutamine stress echocardiography
2012, Egyptian Heart JournalCitation Excerpt :Dobutamine stress echocardiography (DSE) is widely used as a noninvasive method to detect coronary artery disease (CAD) through the estimation of wall-motion abnormalities.1 However, the current method is limited by the artifacts as a result of image quality, the biasness being based on subjective interpretation and dependence on experience.2 To delineate the existing difficulties, the assessment of CAD calls for a method that can be both quantitative and be independent of image quality.
Clinical Use of Doppler Echocardiography and Doppler Tissue Imaging in the Estimation of Myocardial Ischemia During Dobutamine Stress Echocardiography
2008, Journal of the American Society of EchocardiographyEnhanced sensitivity of Dobutamine stress echocardiography by observing wall motion abnormalities during the recovery phase after acute beta-blocker administration
2006, American Journal of CardiologyCitation Excerpt :However, the test has a decreased sensitivity for detection of single-vessel disease.1,2 Sensitivity of DSE for detection of single-vessel disease ranges from 40% to 92% and that for multivessel disease ranges from 65% to 83%, although specificity remains unchanged.8–10 Our study showed that wall motion abnormality assessment during recovery after long-term β blockade significantly increased sensitivity from 81% to 99% (p <0.001) for detection of single-vessel disease, whereas specificity was marginally decreased.
Training in stress echocardiography
2010, Stress Echocardiography: Essential Guide and DVD
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Supported in part by the National Health and Medical Research Council, Australia.