Copyright © 2003 by the European Society of Cardiology.
Regular Articles
Non-invasive diagnosis of coronary artery disease by quantitative stress echocardiography: optimal diagnostic models using off-line tissue Doppler in the MYDISE study
a University of Wales College of Medicine, Cardiff, UK
b University Hospital Benjamin Franklin, Berlin, Germany
c Hôpital Saint Antoine, Paris, France
d Hôpital Charles Nicolle, Rouen, France
e University Hospital Sart Tilman, Liège, Belgium
f University Hospital, Linköping, Sweden
g Huddinge University Hospital, Stockholm, Sweden
* Author for correspondence. Dr Alan G. Fraser, Wales Heart Research Institute, University of Wales College of Medicine, Heath Park, CardiffCF14 4XN, Wales, UK. Tel.: +44-2920-743489; fax: +44-2920-743500
E-mail address: fraiserag{at}cf.ac.uk
Received 10 October 2002; revised 2 December 2002; accepted 11 December 2002
Aims To develop optimal methods for the objective non-invasive diagnosis of coronary artery disease, using myocardial Doppler velocities during dobutamine stress echocardiography.
Methods and results We acquired tissue Doppler digital data during dobutamine stress in 289 subjects, and measured myocardial responses by off-line analysis of 11 left ventricular segments. Diagnostic criteria developed by comparing 92 normal subjects with 48 patients with coronary disease were refined in a prospective series of 149 patients referred with chest pain. Optimal diagnostic accuracy was achieved by logistic regression models, using systolic velocities at maximal stress in 7 myocardial segments, adjusting for independent correlations directly with heart rate and inversely with age and female gender (all p<0.001). Best cut-points from receiver-operator curves diagnosed left anterior descending, circumflex and right coronary disease with sensitivities and specificities of 80% and 80%, 91% and 80%, and 93% and 82%, respectively. All models performed better than velocity cut-offs alone (p<0.001).
Conclusion Non-invasive diagnosis of coronary artery disease by quantitative stress echocardiography is best performed using diagnostic models based on segmental velocities at peak stress and adjusting for heart rate, and gender or age.
Key Words: Stress echocardiography • Tissue Doppler • Dobutamine
CiteULike 
Connotea 
Del.icio.us What's this?
Related articles in EHJ:
- Dobutamine echocardiography: a diagnostic tool comes of age
- Don Poldermans and Jeroen J Bax
EHJ 2003 24: 1541-1542.[Extract] [FREE Full Text]
This article has been cited by other articles:
|
|
 |
|
  R.A. Argyle and S.G. Ray Stress and strain: double trouble or useful tool? Eur J Echocardiogr, August 1, 2009; 10(6): 716 - 722. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. P. Hoole, S. N. Khan, P. A. White, P. M. Heck, R. K. Kharbanda, C. G. Densem, S. C. Clarke, L. M. Shapiro, P. M. Schofield, M. O'Sullivan, et al. Remote ischaemic pre-conditioning does not attenuate ischaemic left ventricular dysfunction in humans Eur J Heart Fail, May 1, 2009; 11(5): 497 - 505. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. P. Abraham and H.-Y. Liang Stress echocardiography diastole to the rescue. J. Am. Coll. Cardiol., February 24, 2009; 53(8): 706 - 708. [Full Text] [PDF]
|
|
|
|
 |
|
 N. Skubas Intraoperative Doppler Tissue Imaging Is a Valuable Addition to Cardiac Anesthesiologists' Armamentarium: A Core Review Anesth. Analg., January 1, 2009; 108(1): 48 - 66. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Marcucci, R. Lauer, and A. Mahajan New Echocardiographic Techniques for Evaluating Left Ventricular Myocardial Function Seminars in Cardiothoracic and Vascular Anesthesia, December 1, 2008; 12(4): 228 - 247. [Abstract] [PDF]
|
|
|
|
 |
|
 N R Van de Veire, J De Sutter, J J Bax, and J R T C Roelandt Technological advances in tissue Doppler imaging echocardiography Heart, August 1, 2008; 94(8): 1065 - 1074. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Sicari, P. Nihoyannopoulos, A. Evangelista, J. Kasprzak, P. Lancellotti, D. Poldermans, J.-U. Voigt, J. L. Zamorano, and on behalf of the European Association of Echocardi Stress echocardiography expert consensus statement: European Association of Echocardiography (EAE) (a registered branch of the ESC) Eur J Echocardiogr, July 1, 2008; 9(4): 415 - 437. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Y. Hayashi, A. Seeberger, B. Lind, S. Gunnes, A. Alvestrand, M. M. d. Nascimento, B. Lindholm, and L.-A. Brodin Acute effects of low and high intravenous doses of furosemide on myocardial function in anuric haemodialysis patients: a tissue Doppler study Nephrol. Dial. Transplant., April 1, 2008; 23(4): 1355 - 1361. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. P. Abraham and A. C. Pinheiro Speckle-Derived Strain: A Better Tool for Quantification of Stress Echocardiography? J. Am. Coll. Cardiol., January 15, 2008; 51(2): 158 - 160. [Full Text] [PDF]
|
|
|
|
|
|
A. Zagatina, N. Zhuravskaya, and A. Kotelnikova Application of tissue Doppler to interpretation of exercise echocardiography: Diagnostics of ischemia localization in patients with ischemic heart disease Eur J Echocardiogr, December 1, 2007; 8(6): 463 - 469. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. P. Abraham, V. L. Dimaano, and H.-Y. Liang Role of Tissue Doppler and Strain Echocardiography in Current Clinical Practice Circulation, November 27, 2007; 116(22): 2597 - 2609. [Full Text] [PDF]
|
|
|
|
 |
|
 X. Hao, E. A. Silva, A. Mansson-Broberg, K.-H. Grinnemo, A. J. Siddiqui, G. Dellgren, E. Wardell, L. A. Brodin, D. J. Mooney, and C. Sylven Angiogenic effects of sequential release of VEGF-A165 and PDGF-BB with alginate hydrogels after myocardial infarction Cardiovasc Res, July 1, 2007; 75(1): 178 - 185. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. G. Svealv, M. S. Tang, F. Waagstein, and B. Andersson Pronounced improvement in systolic and diastolic ventricular long axis function after treatment with metoprolol Eur J Heart Fail, June 1, 2007; 9(6-7): 678 - 683. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C.-M. Yu, J. E. Sanderson, T. H. Marwick, and J. K. Oh Tissue Doppler Imaging: A New Prognosticator for Cardiovascular Diseases J. Am. Coll. Cardiol., May 15, 2007; 49(19): 1903 - 1914. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. B. Ingul, E. Rozis, S. A. Slordahl, and T. H. Marwick Incremental Value of Strain Rate Imaging to Wall Motion Analysis for Prediction of Outcome in Patients Undergoing Dobutamine Stress Echocardiography Circulation, March 13, 2007; 115(10): 1252 - 1259. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. J. D. Owen, C. Rajiv, D. Vinereanu, T. Mathew, A. G. Fraser, and J. H. Lazarus Subclinical Hypothyroidism, Arterial Stiffness, and Myocardial Reserve J. Clin. Endocrinol. Metab., June 1, 2006; 91(6): 2126 - 2132. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Authors/Task Force Members, K. Fox, M. A. A. Garcia, D. Ardissino, P. Buszman, P. G. Camici, F. Crea, C. Daly, G. De Backer, P. Hjemdahl, et al. Guidelines on the management of stable angina pectoris: executive summary: The Task Force on the Management of Stable Angina Pectoris of the European Society of Cardiology Eur. Heart J., June 1, 2006; 27(11): 1341 - 1381. [Full Text] [PDF]
|
|
|
|
|
|
H. Skulstad, S. Urheim, T. Edvardsen, K. Andersen, E. Lyseggen, T. Vartdal, H. Ihlen, and O. A. Smiseth Grading of Myocardial Dysfunction by Tissue Doppler Echocardiography: A Comparison Between Velocity, Displacement, and Strain Imaging in Acute Ischemia J. Am. Coll. Cardiol., April 18, 2006; 47(8): 1672 - 1682. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Lee, R. Campbell, M. Scheuermann-Freestone, R. Taylor, P. Gunaruwan, L. Williams, H. Ashrafian, J. Horowitz, A. G. Fraser, K. Clarke, et al. Metabolic Modulation With Perhexiline in Chronic Heart Failure: A Randomized, Controlled Trial of Short-Term Use of a Novel Treatment Circulation, November 22, 2005; 112(21): 3280 - 3288. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Hedman, B. A. Samad, T. Larsson, E. Zuber, R. Nordlander, and M. Alam Improvement in diastolic left ventricular function after coronary artery bypass grafting as assessed by recordings of mitral annular velocity using Doppler tissue imaging Eur J Echocardiogr, June 1, 2005; 6(3): 202 - 209. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R Senior, M Monaghan, H Becher, J Mayet, and P Nihoyannopoulos Stress echocardiography for the diagnosis and risk stratification of patients with suspected or known coronary artery disease: a critical appraisal. Supported by the British Society of Echocardiography Heart, April 1, 2005; 91(4): 427 - 436. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Quintana, T. Gustafsson, P. Sundblad, and J. Langanger The effects of heart rate on myocardial velocity and atrio-ventricular displacement during exercise with and without beta-blockade: a tissue Doppler echocardiographic study Eur J Echocardiogr, March 1, 2005; 6(2): 127 - 133. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R I Williams, N Payne, T Phillips, J D'hooge, and A G Fraser Strain rate imaging after dynamic stress provides objective evidence of persistent regional myocardial dysfunction in ischaemic myocardium: regional stunning identified? Heart, February 1, 2005; 91(2): 152 - 160. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Saha, J. Nowak, C. Storaa, C.F. Madler, A. Fraser, S. Roumina, B. Lind, and L.-A. Brodin Functional diagnosis of coronary stenosis using tissue tracking provides best sensitivity and specificity for left circumflex disease: experience from the MYDISE (myocardial Doppler in stress echocardiography) study Eur J Echocardiogr, January 1, 2005; 6(1): 54 - 63. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D Pellerin, R Sharma, P Elliott, and C Veyrat Tissue Doppler, strain, and strain rate echocardiography for the assessment of left and right systolic ventricular function Heart, November 1, 2003; 89(90003): iii9 - 17. [Abstract] [Full Text] [PDF]
|
|