Which is the better method in detecting significant left anterior descending coronary artery stenosis during contrast-enhanced dobutamine stress echocardiography: coronary flow velocity reserve or wall-motion assessment?

Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography
Masaaki TakeuchiJ Yoshikawa

Abstract

The diagnostic accuracy of dobutamine stress echocardiography (DSE) depends on wall-motion assessment. Coronary flow velocity reserve (CFVR) during DSE can be measured by transthoracic Doppler echocardiography. To investigate comparative diagnostic accuracy between wall-motion and CFVR assessment in the detection of significant left anterior descending coronary artery (LAD) stenosis, 274 patients underwent both contrast-enhanced DSE and coronary angiography. Intravenous contrast agent, Levovist, was injected to enhance left ventricular endocardial border delineation and coronary flow velocity in the LAD. Wall motion was assessed by standard technique, and CFVR was calculated as coronary flow velocity at peak dobutamine stress divided by baseline coronary flow velocity by transthoracic Doppler echocardiography. CFVR could be successfully obtained in 232 patients (feasibility, 85%). After excluding 14 patients with isolated diagonal stenosis, CFVR was significantly lower in 65 patients with significant LAD stenosis than it was in 153 patients without stenosis (1.62 +/- 0.56 vs 2.72 +/- 0.94, P <.001). CFVR < or = 2.0 had a 75% sensitivity, a 81% specificity, and a 79% diagnostic accuracy for detecting significant LAD stenosis, an...Continue Reading

References

Jun 18, 1992·The American Journal of Cardiology·D S Bach, W F Armstrong
Sep 1, 1997·Journal of the American College of Cardiology·M L GeleijnseJ R Roelandt
Dec 29, 2000·Journal of the American College of Cardiology·M L GeleijnseJ R Roelandt
Jul 14, 2001·Journal of the American College of Cardiology·M TakeuchiJ Yoshikawa
Nov 6, 2001·Journal of the American College of Cardiology·T R PorterE Oleary

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Citations

Apr 29, 2011·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Johnny VegsundvågTorstein Hole
Jun 15, 2011·Annales de cardiologie et d'angéiologie·C JeannotM Giraud
Feb 28, 2006·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Masaaki TakeuchiRoberto M Lang

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