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Transmitral pulsed-Doppler echocardiography is a more accurate technique compared with two-dimensional echocardiography using dobutamine, in patients with one vessel coronary artery disease
To examine the effects of dobutamine on pulsed‐Doppler left ventricular filling indices and its utility for evaluation of CAD we studied 14 patients with normal coronary arteries (Group 1) and 39 patients with significant CAD (>70% diameter stenosis). Patients with coronary artery disease (CAD) w...
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| Published in: | European journal of heart failure 2003-01, Vol.5 (1), p.63-72 |
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| container_title | European journal of heart failure |
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| creator | Bajraktari, Gani Qirko, Spiro Fusco, Rossana Milazzo, Angela Xhaxho, Brunilda Pezzano, Antonio |
| description | To examine the effects of dobutamine on pulsed‐Doppler left ventricular filling indices and its utility for evaluation of CAD we studied 14 patients with normal coronary arteries (Group 1) and 39 patients with significant CAD (>70% diameter stenosis). Patients with coronary artery disease (CAD) were divided into two groups: patients with one‐vessel coronary disease (Group 2); and those with multivessel CAD (Group 3). After stopping cardioactive treatment, patients underwent incremental dobutamine stress (5, 10, 20, 30 and 40 μg/kg/min) during pulsed‐Doppler interrogation of diastolic filling with simultaneous heart rate and blood pressure measurements. The following transmitral Doppler variables were measured at baseline and at peak‐dose of dobutamine: peak early (E) and peak atrial (A) velocity; E/A ratio; acceleration time (AT) and deceleration time (DT) of E wave; isovolumic relaxation time (IVRT); and time–velocity integral (TVI). Two‐dimensional echocardiography was performed to detect regional asinergy and analyzed using a 16 segment model. Results: Normals and CAD patients showed comparable changes in heart rate and blood pressure (P=NS between groups). Intergroup analysis of the changes of transmitral flow showed the significant changes for these indices (P |
| doi_str_mv | 10.1016/S1388-9842(02)00030-2 |
| format | article |
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Patients with coronary artery disease (CAD) were divided into two groups: patients with one‐vessel coronary disease (Group 2); and those with multivessel CAD (Group 3). After stopping cardioactive treatment, patients underwent incremental dobutamine stress (5, 10, 20, 30 and 40 μg/kg/min) during pulsed‐Doppler interrogation of diastolic filling with simultaneous heart rate and blood pressure measurements. The following transmitral Doppler variables were measured at baseline and at peak‐dose of dobutamine: peak early (E) and peak atrial (A) velocity; E/A ratio; acceleration time (AT) and deceleration time (DT) of E wave; isovolumic relaxation time (IVRT); and time–velocity integral (TVI). Two‐dimensional echocardiography was performed to detect regional asinergy and analyzed using a 16 segment model. Results: Normals and CAD patients showed comparable changes in heart rate and blood pressure (P=NS between groups). Intergroup analysis of the changes of transmitral flow showed the significant changes for these indices (P<0.001): E velocity (−2.78±10.04, 12.4±9.4 and 16.47±10.65 cm/s); AT of E wave (1.66±2.47, −5.2±1.38 and −4.66±2.39 m/s2); DT of E wave (−0.23±0.18, 0.2±0.2 and 0.2±0.28 m/s2); and TVI of transmitral flow (−1.26±0.7, 3.5±1.75 and 4.1±1.66 cm), respectively for Groups 1, 2 and 3. All other transmitral Doppler variables showed insignificant changes (P=NS) to dobutamine between groups. It is important that the significance of these changes were the same for patients with one‐vessel and those with multivessel coronary disease. In conclusion, during dobutamine stress testing, patients with CAD, had an abnormal response of these transmitral Doppler indices: E wave; AT of E wave; DT of E wave; and the TVI of transmitral flow. The abnormal responses of these Doppler indices of left ventricular filling are more accurate markers of significant single vessel CAD than new wall motion abnormalities during conventional DSE.</description><identifier>ISSN: 1388-9842</identifier><identifier>EISSN: 1879-0844</identifier><identifier>DOI: 10.1016/S1388-9842(02)00030-2</identifier><identifier>PMID: 12559217</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>Adrenergic beta-Agonists - administration & dosage ; Aged ; Coronary Artery Disease - diagnosis ; Coronary Artery Disease - physiopathology ; Coronary Vessels - diagnostic imaging ; Coronary Vessels - physiopathology ; dobutamine ; Dobutamine - administration & dosage ; doppler echocardiography ; Dose-Response Relationship, Drug ; Echocardiography - methods ; Echocardiography, Doppler, Pulsed - methods ; Echocardiography, Stress ; Female ; Hemodynamics - drug effects ; Humans ; Male ; Middle Aged ; Mitral Valve - diagnostic imaging ; myocardial ischaemia ; Observer Variation ; Prospective Studies ; Sensitivity and Specificity ; stress-echocardiography</subject><ispartof>European journal of heart failure, 2003-01, Vol.5 (1), p.63-72</ispartof><rights>Published on behalf of the European Society of Cardiology. All rights reserved. © 2003 the Authors</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4452-35c375d7d772d830a43dd2c2849ce218212c8b79ce6e3287af1da6c8754ac6673</citedby><cites>FETCH-LOGICAL-c4452-35c375d7d772d830a43dd2c2849ce218212c8b79ce6e3287af1da6c8754ac6673</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12559217$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bajraktari, Gani</creatorcontrib><creatorcontrib>Qirko, Spiro</creatorcontrib><creatorcontrib>Fusco, Rossana</creatorcontrib><creatorcontrib>Milazzo, Angela</creatorcontrib><creatorcontrib>Xhaxho, Brunilda</creatorcontrib><creatorcontrib>Pezzano, Antonio</creatorcontrib><title>Transmitral pulsed-Doppler echocardiography is a more accurate technique compared with two-dimensional echocardiography using dobutamine, in patients with one vessel coronary artery disease</title><title>European journal of heart failure</title><addtitle>European Journal of Heart Failure</addtitle><description>To examine the effects of dobutamine on pulsed‐Doppler left ventricular filling indices and its utility for evaluation of CAD we studied 14 patients with normal coronary arteries (Group 1) and 39 patients with significant CAD (>70% diameter stenosis). Patients with coronary artery disease (CAD) were divided into two groups: patients with one‐vessel coronary disease (Group 2); and those with multivessel CAD (Group 3). After stopping cardioactive treatment, patients underwent incremental dobutamine stress (5, 10, 20, 30 and 40 μg/kg/min) during pulsed‐Doppler interrogation of diastolic filling with simultaneous heart rate and blood pressure measurements. The following transmitral Doppler variables were measured at baseline and at peak‐dose of dobutamine: peak early (E) and peak atrial (A) velocity; E/A ratio; acceleration time (AT) and deceleration time (DT) of E wave; isovolumic relaxation time (IVRT); and time–velocity integral (TVI). Two‐dimensional echocardiography was performed to detect regional asinergy and analyzed using a 16 segment model. Results: Normals and CAD patients showed comparable changes in heart rate and blood pressure (P=NS between groups). Intergroup analysis of the changes of transmitral flow showed the significant changes for these indices (P<0.001): E velocity (−2.78±10.04, 12.4±9.4 and 16.47±10.65 cm/s); AT of E wave (1.66±2.47, −5.2±1.38 and −4.66±2.39 m/s2); DT of E wave (−0.23±0.18, 0.2±0.2 and 0.2±0.28 m/s2); and TVI of transmitral flow (−1.26±0.7, 3.5±1.75 and 4.1±1.66 cm), respectively for Groups 1, 2 and 3. All other transmitral Doppler variables showed insignificant changes (P=NS) to dobutamine between groups. It is important that the significance of these changes were the same for patients with one‐vessel and those with multivessel coronary disease. In conclusion, during dobutamine stress testing, patients with CAD, had an abnormal response of these transmitral Doppler indices: E wave; AT of E wave; DT of E wave; and the TVI of transmitral flow. The abnormal responses of these Doppler indices of left ventricular filling are more accurate markers of significant single vessel CAD than new wall motion abnormalities during conventional DSE.</description><subject>Adrenergic beta-Agonists - administration & dosage</subject><subject>Aged</subject><subject>Coronary Artery Disease - diagnosis</subject><subject>Coronary Artery Disease - physiopathology</subject><subject>Coronary Vessels - diagnostic imaging</subject><subject>Coronary Vessels - physiopathology</subject><subject>dobutamine</subject><subject>Dobutamine - administration & dosage</subject><subject>doppler echocardiography</subject><subject>Dose-Response Relationship, Drug</subject><subject>Echocardiography - methods</subject><subject>Echocardiography, Doppler, Pulsed - methods</subject><subject>Echocardiography, Stress</subject><subject>Female</subject><subject>Hemodynamics - drug effects</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mitral Valve - diagnostic imaging</subject><subject>myocardial ischaemia</subject><subject>Observer Variation</subject><subject>Prospective Studies</subject><subject>Sensitivity and Specificity</subject><subject>stress-echocardiography</subject><issn>1388-9842</issn><issn>1879-0844</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><recordid>eNqNkc-KFDEQhxtR3HX1EZScRMFo_nR30hdBxt1ZZdGDI3sMmaRmJ9qdtEnacR7OdzNjj-7BixCoBL58VcWvqh5T8pIS2r76RLmUuJM1e0bYc0IIJ5jdqU6pFB0msq7vlvsf5KR6kNIXQqgghN2vTihrmo5RcVr9XEXt0-By1D0apz6BxW_DOPYQEZhtMDpaF26iHrd75BLSaAgRkDZmijoDygXy7tsEyIRh1BEs2rm8RXkXsHUD-OSCL-p_XFNy_gbZsJ6yHpyHF8h5NOrswOc0O4IH9B1Sgr7IY9HEPdIxQynWJdAJHlb3NrrM_OhYz6rPF-erxSW--rh8t3hzhU1dNwzzxnDRWGGFYFZyomtuLTNM1p0BRiWjzMi1KI8WOJNCb6jVrZGiqbVpW8HPqqezd4yh7JqyGlwy0PfaQ5iSEqyToia8gM0MmhhSirBRY3RDGVxRog65qd-5qUMoipRzyE2x8u_JscG0HsDe_joGVYDXM7BzPez_z6rO319e3HbAs8ClDD_-CnT8qsqColHXH5Zqwa-ZkKtGLfkvPpu6Og</recordid><startdate>200301</startdate><enddate>200301</enddate><creator>Bajraktari, Gani</creator><creator>Qirko, Spiro</creator><creator>Fusco, Rossana</creator><creator>Milazzo, Angela</creator><creator>Xhaxho, Brunilda</creator><creator>Pezzano, Antonio</creator><general>Blackwell Publishing Ltd</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200301</creationdate><title>Transmitral pulsed-Doppler echocardiography is a more accurate technique compared with two-dimensional echocardiography using dobutamine, in patients with one vessel coronary artery disease</title><author>Bajraktari, Gani ; Qirko, Spiro ; Fusco, Rossana ; Milazzo, Angela ; Xhaxho, Brunilda ; Pezzano, Antonio</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4452-35c375d7d772d830a43dd2c2849ce218212c8b79ce6e3287af1da6c8754ac6673</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Adrenergic beta-Agonists - administration & dosage</topic><topic>Aged</topic><topic>Coronary Artery Disease - diagnosis</topic><topic>Coronary Artery Disease - physiopathology</topic><topic>Coronary Vessels - diagnostic imaging</topic><topic>Coronary Vessels - physiopathology</topic><topic>dobutamine</topic><topic>Dobutamine - administration & dosage</topic><topic>doppler echocardiography</topic><topic>Dose-Response Relationship, Drug</topic><topic>Echocardiography - methods</topic><topic>Echocardiography, Doppler, Pulsed - methods</topic><topic>Echocardiography, Stress</topic><topic>Female</topic><topic>Hemodynamics - drug effects</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mitral Valve - diagnostic imaging</topic><topic>myocardial ischaemia</topic><topic>Observer Variation</topic><topic>Prospective Studies</topic><topic>Sensitivity and Specificity</topic><topic>stress-echocardiography</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bajraktari, Gani</creatorcontrib><creatorcontrib>Qirko, Spiro</creatorcontrib><creatorcontrib>Fusco, Rossana</creatorcontrib><creatorcontrib>Milazzo, Angela</creatorcontrib><creatorcontrib>Xhaxho, Brunilda</creatorcontrib><creatorcontrib>Pezzano, Antonio</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of heart failure</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bajraktari, Gani</au><au>Qirko, Spiro</au><au>Fusco, Rossana</au><au>Milazzo, Angela</au><au>Xhaxho, Brunilda</au><au>Pezzano, Antonio</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Transmitral pulsed-Doppler echocardiography is a more accurate technique compared with two-dimensional echocardiography using dobutamine, in patients with one vessel coronary artery disease</atitle><jtitle>European journal of heart failure</jtitle><addtitle>European Journal of Heart Failure</addtitle><date>2003-01</date><risdate>2003</risdate><volume>5</volume><issue>1</issue><spage>63</spage><epage>72</epage><pages>63-72</pages><issn>1388-9842</issn><eissn>1879-0844</eissn><abstract>To examine the effects of dobutamine on pulsed‐Doppler left ventricular filling indices and its utility for evaluation of CAD we studied 14 patients with normal coronary arteries (Group 1) and 39 patients with significant CAD (>70% diameter stenosis). Patients with coronary artery disease (CAD) were divided into two groups: patients with one‐vessel coronary disease (Group 2); and those with multivessel CAD (Group 3). After stopping cardioactive treatment, patients underwent incremental dobutamine stress (5, 10, 20, 30 and 40 μg/kg/min) during pulsed‐Doppler interrogation of diastolic filling with simultaneous heart rate and blood pressure measurements. The following transmitral Doppler variables were measured at baseline and at peak‐dose of dobutamine: peak early (E) and peak atrial (A) velocity; E/A ratio; acceleration time (AT) and deceleration time (DT) of E wave; isovolumic relaxation time (IVRT); and time–velocity integral (TVI). Two‐dimensional echocardiography was performed to detect regional asinergy and analyzed using a 16 segment model. Results: Normals and CAD patients showed comparable changes in heart rate and blood pressure (P=NS between groups). Intergroup analysis of the changes of transmitral flow showed the significant changes for these indices (P<0.001): E velocity (−2.78±10.04, 12.4±9.4 and 16.47±10.65 cm/s); AT of E wave (1.66±2.47, −5.2±1.38 and −4.66±2.39 m/s2); DT of E wave (−0.23±0.18, 0.2±0.2 and 0.2±0.28 m/s2); and TVI of transmitral flow (−1.26±0.7, 3.5±1.75 and 4.1±1.66 cm), respectively for Groups 1, 2 and 3. All other transmitral Doppler variables showed insignificant changes (P=NS) to dobutamine between groups. It is important that the significance of these changes were the same for patients with one‐vessel and those with multivessel coronary disease. In conclusion, during dobutamine stress testing, patients with CAD, had an abnormal response of these transmitral Doppler indices: E wave; AT of E wave; DT of E wave; and the TVI of transmitral flow. The abnormal responses of these Doppler indices of left ventricular filling are more accurate markers of significant single vessel CAD than new wall motion abnormalities during conventional DSE.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>12559217</pmid><doi>10.1016/S1388-9842(02)00030-2</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | European journal of heart failure, 2003-01, Vol.5 (1), p.63-72 |
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| subjects | Adrenergic beta-Agonists - administration & dosage Aged Coronary Artery Disease - diagnosis Coronary Artery Disease - physiopathology Coronary Vessels - diagnostic imaging Coronary Vessels - physiopathology dobutamine Dobutamine - administration & dosage doppler echocardiography Dose-Response Relationship, Drug Echocardiography - methods Echocardiography, Doppler, Pulsed - methods Echocardiography, Stress Female Hemodynamics - drug effects Humans Male Middle Aged Mitral Valve - diagnostic imaging myocardial ischaemia Observer Variation Prospective Studies Sensitivity and Specificity stress-echocardiography |
| title | Transmitral pulsed-Doppler echocardiography is a more accurate technique compared with two-dimensional echocardiography using dobutamine, in patients with one vessel coronary artery disease |
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