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European Heart Journal 2002 23(7):579-585; doi:10.1053/euhj.2001.2818
Copyright © 2002 by the European Society of Cardiology.
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A comparison of wall motion analysis and systolic left ventricular long axis function during dobutamine stress echocardiography

M.B Mishra, D.A Lythall and J.B Chambersf1

Cardiothoracic Centre, Guy's and St Thomas' Hospital Trust, London, U.K.

revised June 12, 2001; accepted June 13, 2001

Abstract

Aims To compare long-axis function and wall motion analysis for the detection of significant coronary artery stenoses in patients with single and multivessel disease.

Methods and Results We performed dobutamine stress echocardiography in 67 subjects, 14 with normal coronary anatomy, and 53 with significant coronary disease. A blunted increase in mean long-axis shortening of <0·25cm was the best discriminator for coronary artery disease (sensitivity 85%, specificity 81%). Using this threshold, long axis function gave a sensitivity of 88% and specificity 89% for the detection of coronary artery disease in patients with normal resting wall motion while wall motion abnormality analysis had a sensitivity 73% and specificity 94%. Of 26 patients with a resting wall motion abnormality, 14 (54%) had multivessel disease. Long axis function detected multivessel disease in 12 of these (sensitivity 86%) compared with nine (sensitivity 64%) for wall motion analysis.

Conclusion Long axis function provides a promising, quantitative adjunct to wall motion analysis for the detection of coronary ischaemia using dobutamine stress echocardiography in patients with single and multivessel disease and with resting wall motion abnormalities.

Key Words: Long axis, dobutamine stress echocardiography

f1 Correspondence: Dr J.B. Chambers, Department of Cardiology, St Thomas' Hospital, Lambeth Palace Road, London SE1 7EH, U.K.


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