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Early diastolic flow propagation velocity detects induced diastolic dysfunction during dobutamine stress

Takahiro Ohara1, Yuji Hashimoto, Makoto Suzuki

  • 1Cardiology Section, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA. tkohara529@gmail.com

Echocardiography (Mount Kisco, N.Y.)
|February 18, 2011
PubMed

Insights

Flow propagation velocity (FPV) during dobutamine stress echocardiography (DSE) detects diastolic dysfunction in coronary artery disease (CAD). This method improves DSE sensitivity for diagnosing CAD.

Area of Science:

  • Cardiology
  • Diagnostic Imaging
  • Echocardiography

Background:

  • Diastolic dysfunction is an early indicator of myocardial ischemia, preceding systolic dysfunction.
  • Detecting diastolic dysfunction during stress testing can enhance the diagnostic accuracy for coronary artery disease (CAD).
  • Flow propagation velocity (FPV), measured by color M-mode Doppler, is a potential sensitive marker for diastolic dysfunction.

Purpose of the Study:

  • To evaluate the utility of FPV measurement during dobutamine stress echocardiography (DSE) for detecting diastolic dysfunction in patients with suspected CAD.
  • To assess if FPV can improve the diagnostic sensitivity of DSE for CAD.
  • To compare FPV changes between patients with and without CAD during DSE.

Main Methods:

  • Color M-mode Doppler was used to measure FPV at baseline and peak dobutamine infusion in 90 patients undergoing DSE.
  • Patients were categorized based on coronary angiography results.
  • FPV values were compared across groups, and receiver operating characteristic (ROC) analysis was performed.

Main Results:

  • Baseline FPV was similar across all groups.
  • At peak dobutamine, FPV significantly increased in the non-CAD group but failed to increase in CAD groups, resulting in lower peak FPV in CAD patients.
  • Peak FPV and the change in FPV (ΔFPV) demonstrated good diagnostic properties for CAD detection (AUCs of 0.77 and 0.73, respectively), improving DSE sensitivity.

Conclusions:

  • FPV measurement during DSE effectively detects ischemic left ventricular diastolic dysfunction.
  • Incorporating peak FPV assessment into conventional DSE enhances sensitivity and reliability in excluding CAD.
  • FPV is a valuable tool for improving the diagnostic capability of stress echocardiography in CAD evaluation.
Abstract

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