Pulsed tissue Doppler imaging for the detection of myocardial ischaemia, a comparison with myocardial perfusion SPECT

• In order to compare the diagnostic ability of pulsed tissue Doppler and myocardial perfusion Single Photon Emission Computed Tomography (SPECT) in patients with a history of unstable coronary artery disease, CAD, 26 patients, 22 men and four women, age 47-76 years, were investigated in a prospective study, 5-10 day after an episode of unstable angina. Tissue Doppler and two-dimensional echocardiography were performed during dobutamine stress testing and myocardial scintigraphy after bicycle exercise and at rest. Patients with a normal SPECT had higher peak systolic velocity during dobutamine infusion, 18.9 ± 4.1 cm s-1, than patients with ischaemia, 12.2 ± 3.8 cm s-1 (P<0.001) or scar, 8.8 ± 3.0 cm s-1 (P<0.01). In a territorial analysis the difference in peak systolic velocity between areas with a normal and abnormal SPECT was less apparent. Failure to achieve ≥13 cm s-1 in mean-peak systolic velocity was the most accurate criterion for detection of significant CAD on SPECT. We conclude that pulsed tissue Doppler can be used for objective quantification of left ventricular wall motion during dobutamine stress testing and for identification of patients with CAD on SPECT but not for identification of regional ischaemia.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

Keyword

Dobutamine

Echocardiography

Myocardial perfusion SPECT

Tissue Doppler

atropine

tetrofosmin tc 99m

adult

aged

article

bicycle ergometry

clinical article

clinical trial

controlled clinical trial

controlled study

diagnostic value

Doppler echocardiography

drug infusion

female

heart left ventricle contraction

heart left ventricle wall motion

heart perfusion

human

image analysis

intermethod comparison

ischemic heart disease

male

priority journal

prospective study

rest

scintillation camera

single photon emission computer tomography

statistical significance

stress echocardiography

two dimensional echocardiography

unstable angina pectoris

MEDICINE

Publication and Content Type

ref (subject category)

art (subject category)