Dobutamine stress echocardiography combined with tissue Doppler imaging detecting hibernating myocardium Quantitatively in patients with coronary artery disease

Objective To detect viable myocardium quantitatively,and improve the rate of detecting viable myocardium by Doppler Tissue Imaging during dobutamine stress echocardiography(DSE).Methods 25 cases who had been admitted for a quantitative coronary angiography(QCA)with at least one of the coronary lesion larger than 50% of luminal diameter occlusion were enrolled in standard dobutamine stress echocardiography(DSE).Left ventricule wall motion were graded and marked in a semi-quantitative motion using the standard 16-segment 4-score model.Wall motion score index(WMSI) was calculated.The development of the new or worsening regional wall motion abnormality was considered indicatively of positive DSE[DSE(+)].From DTI spectrum,both peak systolic velocity(Vs),peak early diastolic velocity(Ve),peak late velocity(Va) were measured in each segment at base line,10μg/Kg.min and peak-dose dobutamine infusion.The sensitivity,specificity,positive predictive value(PPV),negative predictive value(NPV),and accuracy were calculated after the results of DSE were compared with those of Percutaneous transluminal intervention(PCI).Results The peak velocity of Doppler Tissue Imaging was gained in 16 segments of left ventricular of every patients,and the ΔVS and δVE≥35% were regarded as the standard of double response.The rate of detecting viable myocardium using DTI-DSE was 76%,while 2D-DSE was 66%,the difference was significantly.The sensitivity,specificity,positive predictive value(PPV),negative predictive value(NPV),and accuracy were:2D-DSE:68%、80%、73%、87% and 82% respectively;and DTI-DSE:82%、88%、86%、84%and 85% respectivel.Conclusions DTI-DSE could detect hibernating myocardium quantitatively in patients of CAD,and the rate of detecting viable myocardium was improved significantly.