A comparison of wall motion analysis and systolic left ventricular long axis function during dobutamine stress...

Area of Science:

• Cardiovascular Medicine
• Diagnostic Imaging
• Echocardiography

Background:

• Coronary artery disease (CAD) diagnosis relies on identifying significant stenoses.
• Echocardiography, particularly stress echocardiography, is crucial for assessing cardiac function and detecting ischemia.
• Distinguishing between single and multivessel disease impacts treatment strategies.

Purpose of the Study:

• To compare the efficacy of long-axis function analysis versus wall motion analysis.
• To evaluate the detection of significant coronary artery stenoses in patients with single and multivessel disease.
• To assess the diagnostic performance of dobutamine stress echocardiography (DSE) in CAD detection.

Main Methods:

• Dobutamine stress echocardiography (DSE) was performed on 67 subjects.
• Subjects included 14 with normal coronary anatomy and 53 with significant coronary disease.
• Analysis focused on mean long-axis shortening and resting wall motion abnormalities.

Main Results:

• A blunted increase in mean long-axis shortening (<0.25 cm) was the best discriminator for CAD (sensitivity 85%, specificity 81%).
• Long axis function demonstrated higher sensitivity (88%) and specificity (89%) for CAD detection compared to wall motion analysis (sensitivity 73%, specificity 94%) in patients with normal resting wall motion.
• Long axis function detected multivessel disease in 12 of 26 patients (sensitivity 86%) with resting wall motion abnormalities, outperforming wall motion analysis (sensitivity 64%).

Conclusions:

• Long axis function serves as a promising quantitative adjunct to wall motion analysis in DSE.
• It aids in detecting coronary ischemia, particularly in patients with single and multivessel disease, and those with resting wall motion abnormalities.
• This quantitative approach enhances the diagnostic capability of stress echocardiography for coronary artery stenosis.