Speckle tracking echocardiography combined with low dose dobutamine stress in predicting therapeutic effect of percutaneous coronary intervention

Objective To evaluate the feasibility and diagnostic accuracy of speckle tracking echocardiography(STE) combined with low-dose dobutamine stress(DSE) for prediction therapeutic effect of percutaneous coronary intervention(PCI).Methods Forty patients with ischemic heart disease before PCI were included.The longitudinal peak systolic strain rate(SRs) at rest and at DSE was analyzed.Cardiac ultrasound was performed on all patients 9 months after PCI,and improvement of wall-motion score was taken as standard of evaluation.Results Among 225 segments with abnormal resting motion,functional recovery was found in 101(44.89%),while no recovery was found in 124 segments(55.11%) after PCI.At baseline dobutamine echocardiography,72 viable segments were accurately predicted by wall-motion analysis,yielding a sensitivity of 71.29%(72/101),while 87 of 124 segments that did not recover after revascularization were accurately predicted by wall-motion analysis,yielding a specificity of 70.16%(87/124).The area under ROC curves was 0.76,cut-off value of SRs was-0.49,the sensitivity was 71.30% and specificity was 70.20% at rest-state STE.For STE combining with DSE,the area under ROC curves was 0.89,cut-off value of SRs was-0.75,the sensitivity was 89.10% and specificity was 90.30%.SRs of the viable segments were found significantly increased than those did not recovered(P0.01) when observed with STE.Conclusion Combination of STE with DSE can predict myocardial viability accurately.The presence of potential and functional viable myocardium is necessary in screening indication and forecasting the therapeutic effect of PCI.