Korean Circ J.  2013 Jun;43(6):384-390. 10.4070/kcj.2013.43.6.384.

Assesment of Myocardial Ischemia by Combination of Tissue Synchronisation Imaging and Dobutamine Stress Echocardiography

• Tas MH
• Aksakal E
• Gurlertop
• Simsek Z
• Gundogdu F
• Sevimli S
• Bakirci EM
• Karakelleoglu S

• KMID: 2224899
• DOI: http://doi.org/10.4070/kcj.2013.43.6.384

Abstract

BACKGROUND AND OBJECTIVES
Dobutamine stress echocardiography (DSE) is an important non-invasive imaging method for evaluating ischemia. However, wall motion interpretation can be impaired by the experience level of the interpreter and the subjectivity of the visual assessment. In our study we aimed to combine DSE and tissue syncronisation imaging to increase sensitivity for detecting ischemia.
SUBJECTS AND METHODS
50 patients with indications for DSE were included in the study. In 25 patients we found DSE positive for ischemia and in the other 25 patients we found it to be negative. The negative group was accepted as the control group. There was no significant difference in terms of risk factors and echocardiographic parameters between the two groups, except for wall motion scores. In both groups, left ventricular dyssychrony was accepted as the difference between time to peak systolic velocity (Ts) in the reciprocal four couple of non-apical segments at rest and during peak stress. Timings were corrected for heart rate. We compared the differences of the dyssynchronisation value at rest and during peak stress to determine the distinctions within the groups and between the groups of DSE positive and negative patients.
RESULTS
We found that stress and ischemia did not create any significant difference over the left intraventricular dyssynchrony with DSE, although at the segmenter level it prolonged the time to peak systolic velocity (p<0.05). These alterations did not show any significant difference between positive and negative DSE groups.
CONCLUSION
As a result, this segmenter dyssynchrony and the time to peak systolic velocity, which is corrected for heart rate, did not enhance any new value over DSE for detecting ischemia.

Keyword

Dobutamine stress echocardiography; Ischemia; Tissue Synchronisation Imaging

MeSH Terms

Dobutamine
Echocardiography, Stress
Equidae
Heart Rate
Humans
Ischemia
Myocardial Ischemia
Risk Factors
Dobutamine

Figure

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  Fig. 1 Tissue synchronisation imaging and measurements of intraventricular dyssynchrony at 2 chamber and 4 chamber images.

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  Fig. 2 Dobutamin stress echocardiography images at 40 mcgr/kg/minute.

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