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European Heart Journal 1995 16(10):1420-1424;
Copyright © 1995 by the European Society of Cardiology.
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© 1995 The European Society of Cardiology

Dobutamine echocardiography: usefulness of digital image processing

D. CASTINI, F. GENTILE, M. ORNAGHI, E. MONTANI, A. LIPPOLIS, E. MANGIAROTTI, D. ESPOSTI, D. CIRINO and G. C. MAGGI

Department of Cardiology-UCC ‘Marco Oscar Triulzi’ Bassini Hospital Milano, Italy

revised 25 October 1994; accepted 21 December 1994.

Correspondence: Diego Castini MD. Via della Martinella, 9 20152 Milano. Italy

Abstract

The present study was undertaken in order specifically to evaluate the usefulness of digital image processing so as to enhance the diagnostic power of dobutamine stress echocardiography. For this purpose 44 dobutamine echocardio-graphic tests, routinely performed in our echo laboratory, were analysed blindly by two observers using traditional videotape recording and digitized image acquisition.

The results obtained from both observers show a trend which suggests that the traditional videotape approach provides more true-positive tests than the digitized approach (27138 vs 23138 and 24138 vs 22138 for the first and second observer, respectively). True-negative test detection was 6/6 with the videotape and 5/6 with the digitized method for both observers. As a consequence of the discrepancies observed between the two modalities, the videotape indicates that it can provide higher diagnostic accuracy than the digitized approach (72 ± 9% vs 63 ± 10%). The tests results concordance (positive or negative) between the two modalities of analysis was 66% for both the observers. The inter-observer agreement on the test results was 84% and 80% for the videotape analysis and the digitized analysis, respectively.

On the basis of the results, we consider that digitized analysis applied to dobutamine stress echocardiography does not afford significant diagnostic advantages and should not be considered as an alternative option to traditional videotape analysis. However, it may be considered an extremely useful integrative tool since it produces the on-line image evaluation more easily and faster and allows a more practical form of stress test storage.

Key Words: Digital echocardiography • dobutamine echocardiography • stress echocardiography


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