Changes in left ventricular filling pattern during dobutamine stress Doppler echocardiography

European Journal of Echocardiography : the Journal of the Working Group on Echocardiography of the European Society of Cardiology
V BodíA Llácer

Abstract

To study the left ventricular filling pattern during stress Doppler echocardiography and its utility in the detection of myocardial ischaemia. Fifty-seven consecutive patients underwent dobutamine stress echocardiography. The left ventricular filling pattern (E-wave velocity; A-wave velocity; E/A ratio; E-wave deceleration time) was analysed at baseline and at maximum heart rate reached. The percentage increase in these parameters from baseline to peak heart rate was also determined. Myocardial ischaemia (regional contractility worsening) was induced in 19 cases (ischaemic group) but not in 38 cases (non-ischaemic group). There were no differences between both groups at baseline. E-wave deceleration time decreased in the non-ischaemic group (197+/-63 vs. 167+/-65 ms, P=0.01) and increased in the ischaemic group (203+/-42 vs. 315+/-135 ms, P<0.0001). A percentage increase in E-wave deceleration time of >30% showed a positive predictive value of 93% and a negative predictive value of 86% for detecting ischaemia, and in the multivariate analysis it was the only Doppler parameter (P<0.0001) that predicted the induction of ischaemia. We conclude that myocardial ischaemia provokes an increase in E-wave deceleration time. Analysis of ...Continue Reading

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