European Heart Journal Advance Access originally published online on May 23, 2006
European Heart Journal 2006 27(14):1719-1724; doi:10.1093/eurheartj/ehl023
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Comparison of real-time tri-plane and conventional 2D dobutamine stress echocardiography for the assessment of coronary artery disease
Department of Cardiology, University Hospital Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium
Received 7 April 2005; revised 31 March 2006; accepted 20 April 2006; online publish-ahead-of-print 23 May 2006.
* Corresponding author. Tel: +32 16 344840; fax: +32 16 344240. E-mail address: frank.rademakers{at}uz.kuleuven.be
See page 1646 for the editorial comment on this article (doi:10.1093/eurheartj/ehl091)
Aims Although dobutamine stress echocardiography (DSE) is an accepted tool for the diagnosis of coronary artery disease (CAD), it requires subsequent image acquisitions of the left ventricle (LV) in order to visualize all segments. This makes the procedure relatively time-consuming and might limit its accuracy. With the introduction of matrix array transducers, the real-time simultaneous acquisition of all LV segments has become possible using multi-plane imaging. The purpose of this study was: (i) to test the feasibility and efficiency of real-time tri-plane (RT3P) imaging during DSE, (ii) to compare the accuracy of RT3P DSE in detecting CAD using coronary angiography as the reference method.
Methods and results Thirty-six patients suspected of CAD were prospectively enrolled. Both conventional two-dimensional (2D) and RT3P imaging were performed during a DSE protocol. Coronary angiography was performed within 24 h. Ultrasound data were acquired at each stage of the DSE. The total effective acquisition time for RT3P imaging was significantly shorter (55±29 vs. 137±63 s, P<0.001). Data yield was similar for both methods (2D: 98% vs. 3D: 97%). Overall sensitivity (93%), specificity (75%), and accuracy (89%) were identical between both methods. On a segmental level, the sensitivity, specificity, and accuracy of the RT3P and the 2D DSE were similar.
Conclusion RT3P imaging fastens the DSE protocol without compromising the accuracy for the diagnosis of CAD. This could facilitate a more wide-spread use of DSE and therefore contributes positively to its routine clinical acceptance.
Key Words: Multiplane imaging • Three-dimensional • Dobutamine stress echocardiography • Coronary artery disease
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