Assessment of left ventricular ejection dynamics in patients with coronaryartery disease during dipyridamole-stress Doppler echocardiography

Objectives To investigate the contribution of Doppler-echocardiographically derived aortic indexes of left ventricular systolic function during dipyri damole-stress to the diagnosis of coronary artery disease (CAD), Design This was a clinical study. Methods Echocardiographic studies under baseline and peak dipyridamole stre sses were performed on 15 normal subjects and 32 patients with angiographic ally confirmed CAD. Peak Doppler velocity acceleration, and acceleration ti me of the ascending aorta, as well as segmental left ventricular wail motio n, were analyzed. Results The sensitivity, specificity and overall accuracy of wall-motion ab normalities induced by dipyridamole for the detection of CAD were 62.5, 100 , and 74.5%, respectively. When wall-motion abnormalities were combined wit h the percentage changes in peak aortic velocity and acceleration, the over all sensitivities were 84.38 and 78.15%, respectively, the specificities we re 66.7 and 80.00%, respectively and the accuracy was 78.72% for both model s. When all three parameters were combined, the sensitivity, specificity an d overall accuracy of the method were 875, 86.7, and 87.2%, respectively. Conclusions Doppler-echocardiographically derived aortic indexes of left ve ntricular systolic function during dipyridamole stress could be a useful ad junct to two-dimensional echocardiography by improving its sensitivity in t he diagnosis of CAD. Coronary Artery Dis 10:471-477 (C) 1999 Lippincott Wil liams & Wilkins.