QUANTITATIVE-EVALUATION OF THE SEGMENTAL LEFT-VENTRICULAR RESPONSE TODOBUTAMINE STRESS BY TISSUE DOPPLER-ECHOCARDIOGRAPHY

Tissue Doppler imaging displays color-coded myocardial velocity on-lin e and has potential to objectively quantify regional left ventricular function. Sixty patients, aged 56 +/- 10 years, were studied to determ ine the normal and abnormal segmental endocardial velocity response to dobutamine stress, and the sensitivity, specificity, and accuracy of tissue Doppler imaging for detecting abnormal wall motion at peak stre ss as defined by routine visual interpretation, Separate 2-dimensional routine gray scale and color tissue Doppler image sets were acquired at rest and peak dobutamine stress in a digital cineloop format, Routi ne wall motion interpretation from gray scale images and color-coded p eak systolic endocardial velocity from tissue Doppler images were dete rmined independently Twenty-two patients who reached their target hear t rate and had normal wall motion at peak stress served as a control g roup, There were 19 patients who had wall motion abnormalities at peak stress, Segmental peak endocardial velocities increased significantly in all segments in the control group. Endocardial velocity was signif icantly Bower at peak stress in the pooled abnormal segments than in t he pooled normal segments: 3.1 +/- 1,2 versus 7.2 +/- 1.9 cm/s, respec tively (p < 0,05 vs normal control). However, the velocity response of abnormal apical segments could not be distinguished from normal contr ols by tissue Doppler imaging. Excluding apical segments, a peak veloc ity of less than or equal to 5.5 cm/s with peak stress had an average sensitivity of 96%, specificity of 81%, and accuracy of 86% for identi fying abnormal segments at peak stress as defined by routine 2-dimensi onal criteria. Tissue Doppler imaging has the potential to quantify re gional left ventricular function during dobutamine stress. (C) 1997 by Excerpta Medica, Inc.