DETECTION OF LEFT-VENTRICULAR SYSTOLIC AND DIASTOLIC ABNORMALITIES INPATIENTS WITH CORONARY-ARTERY DISEASE BY COLOR KINESIS

Background: Color kinesis (CK) is a recently developed echocardiograph ic technique based on acoustic quantification that automatically track s and displays endocardial motion in real time and has been used in in itial studies to improve the evaluation of global and regional wall mo tion. Hypothesis: For further validation of the use of CK for analysis of segmental ventricular dysfunction, we assessed its sensitivity and specificity for detection of regional systolic and diastolic wall mot ion abnormalities in patients with coronary artery disease (CAD). Meth ods: Two-dimensional (2-D) echocardiography and CK were used to study 15 normal subjects and 63 patients with technically good quality echoc ardiographic tracings, who underwent coronary arteriography within 1 m onth of echocardiography. Significant (>70% luminal diameter stenosis) CAD was present in 50 patients (79%). Results: Color kinesis tracked endocardial motion accurately in 93% of left ventricular segments. Wal l motion score, systolic segmental endocardial motion (SEM), and the t ime of systolic SEM (tSEM) and diastolic (tDEM) segmental endocardial motion were calculated. Intra-and interobserver variability were withi n narrow limits. SEM and tSEM were significantly lower and tDEM was si gnificantly higher in the patient population than in the control group (p<0.001). Comparison between CK and 2-D echocardiography showed a co rrelation coefficient of 0.81 between the two techniques. The score wa s identically graded in 74% of segments, with concordance of 82% in di agnosing segments as abnormal. Interobserver concordance was 86% for C K (r = 0.85) and 81% for 2-D echocardiography (r = 0.80). The sensitiv ity and specificity of systolic and diastolic CK parameters for the de tection of CAD were 88 and 92% and 77 and 85%, respectively. The posit ive predictive values were 93 and 96%, respectively, the negative pred ictive values were 63 and 73%, respectively, and the overall accuracy was 86 and 91%, respectively. Conclusions: Our data suggest that CK is a feasible and sensitive technique for identifying regional systolic as well as diastolic wall motion abnormalities in patients with CAD.