%0 Journal Article
%T Quantitative approach using multiple single parameters versus visual assessment in dobutamine stress echocardiography
%A Jelena Celutkiene
%A Diana Zakarkaite
%A Viktor Skorniakov
%A Vida Zvironaite
%A Virginija Grabauskiene
%A Jelizaveta Burca
%A Laura Ciparyte
%A Aleksandras Laucevicius
%J Cardiovascular Ultrasound
%D 2012
%I BioMed Central
%R 10.1186/1476-7120-10-31
%X Prospective analysis included data of 151 patients (age 61.8£¿¡À£¿9.2) who underwent dobutamine stress echocardiography for known (n£¿=£¿35) or suspected coronary artery disease (CAD) (n£¿=£¿36) or symptomatic chest pain (n£¿=£¿80), excluding patients with previous myocardial infarction. Systolic, post-systolic and diastolic velocities, strain and strain rate parameters were obtained at rest and at peak dobutamine challenge. Derivative markers as E'/A' ratio, post-systolic index and changes from rest to stress were calculated (98 parameters overall, predominantly longitudinal). Coronary angiography was chosen as reference method considering at least one stenosis ¡Ý70% per patient as significant CAD. The predictive value of quantitative parameters and wall motion score index (WMSI) was obtained using logistic regression and ROC analysis.The value of single parameters discriminated as independent predictors of CAD appeared to be modest (area under the curve [AUC] ranged from 0.63 to 0.72 for 16 PW-DMI, 12 CC-DMI and 12 STI markers), comparing to AUC of WMSI 0.88. Sensitivity, specificity and accuracy of visual DSE evaluation was 82.4% (95%CI 77.4%; 85.2%), 92.6% (95%CI 83.4%; 97.5%) and 86.0% (95%CI 79.5%; 89.6%), respectively, Youden index 0.75. Sensitivity, specificity and accuracy of single predictors ranged from 40.0% to 93.3% (95% CI 22.7%; 99.2%), from 34.2% to 88.7% (95% CI 25.6%; 94.1%) and from 45.8% to 80.0% (95% CI 37.5%; 87.2%) respectively, Youden index ranged from 0.20 to 0.52.Multiple single quantitative parameters showed limited predictive ability to identify significant coronary artery stenosis. Visual assessment of DSE appears to be more accurate than single velocity and strain/strain rate markers in the diagnosis of CAD.Pharmacologic stress echocardiography is an established cost-effective technique for the detection and prognostication of coronary artery disease (CAD) [1], however, it is highly subjective and relies on echocardiographer¡¯s experience. Several
%K Coronary artery disease
%K Coronary stenosis
%K Dobutamine stress echocardiography
%K Myocardial deformation imaging
%K Strain/strain rate imaging
%K Doppler myocardial imaging
%K Tissue doppler imaging
%K Speckle tracking
%U http://www.cardiovascularultrasound.com/content/10/1/31