VALIDITY OF ACOUSTIC QUANTIFICATION COLOR KINESIS FOR DETECTION OF LEFT-VENTRICULAR REGIONAL WALL-MOTION ABNORMALITIES - A TRANSESOPHAGEAL ECHOCARDIOGRAPHIC STUDY

Transoesophageal echocardiography is a sensitive monitor for intraoper ative myocardial ischaemia. Colour kinesis is a new technology for ech ocardiographic assessment of regional wall motion based on acoustic qu antification. We have examined the feasibility and accuracy of quantit ative segmental analysis of colour kinesis images to provide objective evaluation of systolic regional wall motion during the perioperative period using echocardiography (TOE). Two-dimensional echocardiograms w ere obtained in the transgastric short-axis and long-axis views in 60 patients with coronary artery disease undergoing non-cardiac surgery. End-systolic colour overlays superimposed on the grey scale images wer e obtained with colour kinesis to colour encode left: ventricular endo cardial motion throughout systole. These colour-encoded images were di vided into segments and compared with corresponding conventional two-d imensional images. Six hundred of a potential 720 left ventricular wal l segments were of sufficient resolution for grading by experts; they diagnosed wall motion abnormalities in 61 of these segments by a conve ntional method. In comparing the conventional TOE method with colour k inesis, there were 60 true positives, 482 true negatives, 57 false pos itives and 1 false negative result. This yielded a sensitivity of 98%, specificity of 89%, positive predictive value of 51% and negative pre dictive value of 100%. Translational and rotational movement of the he art and papillary muscle interference were common problems accounting for false positive diagnoses. We conclude that colour kinesis provides a basis for objective and on-line evaluation of left ventricular regi onal wall motion which is a sensitive but non-specific method. It may be a useful aid for the less experienced because it can potentially di rect the anaesthetist's attention towards specific segments.