Comparison of quantitative wall-motion analysis and strain for detection of coronary stenosis with three-dimensional dobutamine stress echocardiography

Academic Article

Abstract

  • BackgroundQuantitative analysis of wall motion from three-dimensional (3D) dobutamine stress echocardiography (DSE) could provide additional diagnostic information not available from qualitative analysis. In this study, we compare the effectiveness of 3D fractional shortening (3DFS), a measure of wall motion computed from 3D echocardiography (3DE), to strain and strain rate measured with sonomicrometry for detecting critical stenoses during DSE.MethodsEleven open-chest dogs underwent DSE both with and without a critical stenosis. 3DFS was measured from 3DE images acquired at peak stress. 3DFS was normalized by subtracting average 3DFS during control peak stress (Δ3DFS). Strains in the perfusion defect (PD) were measured from sonomicrometry, and PD size and location were measured with microspheres.ResultsA Δ3DFS abnormality indicated the presence of a critical stenosis with high sensitivity and specificity (88% and 100%, respectively), and Δ3DFS abnormality size correlated with PD size (R2 = 0.54). The sensitivity and specificity for Δ3DFS were similar to that for area strain (88%, 100%) and circumferential strain and strain rate (88%, 92% and 88%, 86%, respectively), while longitudinal strain and strain rate were less specific. Δ3DFS correlated significantly with both coronary flow reserve (R2 = 0.71) and PD size (R2 = 0.97), while area strain correlated with PD size only (R2 = 0.67), and other measures were not significantly correlated with flow reserve or PD size.ConclusionQuantitative wall-motion analysis using Δ3DFS is effective for detecting critical stenoses during DSE, performing similar to 3D strain, and provides potentially useful information on the size and location of a perfusion defect.
  • Authors

    Digital Object Identifier (doi)

    Pubmed Id

  • 21126707
  • Author List

  • Parker KM; Clark AP; Goodman NC; Glover DK; Holmes JW
  • Start Page

  • 349
  • End Page

  • 360
  • Volume

  • 32
  • Issue

  • 2