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European Heart Journal 1997 18(10):1590-1598;
Copyright © 1997 by the European Society of Cardiology.
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© 1997 The European Society of Cardiology

Effects of atrial pacing stress test on ultrasonic integrated backscatter cyclic variations in normal subjects and in patients with coronary artery disease

S. Iliceto*,, L. Galiuto, P. Colonna*, V. F. Napoli and P. Rizzon

Institutes of Cardiology, University of Bari Italy
*Cagliari Italy

revised 3 April 1997; accepted 16 April 1997.

Correspondence: Prof. Sabino Iliceto, MD, Institute of Cardiology, PO S. Giovanni di Dio. University of Cagliari, Via Ospedale 46, 09124 Cagliari, Italy

Abstract

AIMS: To evaluate the effects of acute, atrial pacing-induced, reversible myocardial ischaemia on myocardial thickening and integrated backscatter cyclic variations in patients with or without coronary artery disease.

MEHTODS AND RESULTS: Thirty-six patients with suspected coronary artery disease underwent transoesophageal echocardiography with simultaneous atrial pacing, and coronary angiography. In myocardial segments not related to a significantly narrowed coronary artery, both from patients with and without coronary artery disease, thickening and integrated backscatter cyclic variations were not reduced at peak pacing. In segments related to a significantly narrowed coronary artery, thickening decreased at peak pacing, was still reduced at pacing interruption and recovered at 2 mm, while backscatter cyclic variations, blunted at peak pacing, immediately recovered after pacing interruption.

CONCLUSIONS: During stress-induced myocardial ischaemia, backscatter cyclic variations are blunted and thickening reduced. Returning to baseline, pre-atrial pacing values occur more rapidly in backscatter cyclic variations than when thickening takes place. Evaluation of stress-induced alterations in backscatter cyclic variations may aid in the identification of ischaemia-induced regional left ventricular functional impairment and, hence, in coronary artery disease diagnosis.

Key Words: Integrated backscatter • transoesophageal echocardiography • stress-induced ischaemia • myocardial thickening


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