Use of tissue Doppler imaging to facilitate the prediction of events in patients with abnormal left ventricular function by dobutamine echocardiography

The extent of abnormality in patients with positive dobutamine echocardiography (DE) is predictive of risk, but the wall motion score (WMS) has low concordance among observers. We sought whether quantifying the extent of abnormal wall motion using tissue Doppler (TD) could guide risk assessment in p...

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Bibliographic Details
Published in:The American journal of cardiology 2004-01, Vol.93 (2), p.142-146
Main Authors: Marwick, Thomas H, Case, Colin, Leano, Rodel, Short, Leanne, Baglin, Terri, Cain, Peter, Garrahy, Paul
Format: Article
Language:English
Subjects:
Biological and medical sciences
Cardiology. Vascular system
Coronary Disease - mortality
Echocardiography, Doppler, Color
Echocardiography, Stress
Female
Follow-Up Studies
Heart
Humans
Male
Medical sciences
Middle Aged
Myocardial Contraction
Myocardial Infarction - epidemiology
Predictive Value of Tests
Prognosis
Prospective Studies
Time Factors
Ventricular Dysfunction, Left - diagnostic imaging
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Summary:The extent of abnormality in patients with positive dobutamine echocardiography (DE) is predictive of risk, but the wall motion score (WMS) has low concordance among observers. We sought whether quantifying the extent of abnormal wall motion using tissue Doppler (TD) could guide risk assessment in patients with abnormal DE in 576 patients with known or suspected coronary artery disease; standard DE was combined with color TD imaging at peak dose. WMS was assessed by an expert observer and studies were identified as abnormal in the presence of ≥1 segments with resting or stress-induced wall motion abnormalities. Patients with abnormal DE had peak systolic velocity measured in each segment. Tissue tracking was used to measure myocardial displacement. Follow-up for death or infarction was performed after 16 ± 12 months. Of 251 patients with abnormal DE, 22 patients died (20 from cardiac causes) and 7 had nonfatal myocardial infarctions. The average WMS in patients with events was 1.8 ± 0.5, compared with 1.7 ± 0.5 in patients without events (p = NS). The average systolic velocity in patients with events was 4.9 ± 1.7 cm/s and 6.4 ± 6.5 cm/s in the patients without events (p
ISSN:0002-9149
1879-1913
DOI:10.1016/j.amjcard.2003.09.029