Comparison of postexercise and transesophageal atrial pacing two-dimensional echocardiography for detection of coronary artery disease

Iliceto, Sabino; D’Ambrosio, G; Sorino, Margherita; Papa, Antonietta; Amico, Antonio; Ricci, Antônio; Rizzon, Paolo

doi:10.1016/0002-9149(86)90832-5

Cited by 65 publications

(6 citation statements)

References 27 publications

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“…Moreover, the suggested method is applicable to patients with orthopedic, vascular, and neurologic deficits, as the pa tient collaboration is minimal when compared to exer cise studies and transesophageal pacing techniques. Transesophageal pacing with 2DE has been used recently without correlation to pacing during RNA [12,13]. As reported by Chapman et al [13], all normal volunteers complained that the sensation due to esophageal atrial pacing was disagreeable.…”

Section: Discussionmentioning

confidence: 99%

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Diagnosis of Coronary Artery Disease by Two-Dimensional Echocardiography versus Radionuclide Angiography during Stress Atrial Pacing

Abinader¹,

Hassan²,

Goldhamer³

et al. 1990

Am J Noninvas Cardiol

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Transvenous stress atrial pacing (SAP) was performed in conjunction with two-dimensional echocardiography (2DE) and compared to radionuclide angiography (RNA) in 15 patients with coronary artery disease (CAD). In addition, 10 normal subjects underwent SAP-2DE only. The test was successful in 93.3 % of the CAD patients and in all normal subjects. Echocardiographie images of good quality were obtained at rest and throughout atrial pacing in all subjects. In normal subjects the ejection fraction (EF) increased from 62 ± 6.3 to 64 ± 7% during maximal SAP (p = NS). None showed wall motion abnormalities (WMA) at rest or during SAP. In the CAD group the EF decreased from 46.5 ± 11 to 30 ± 7% (p < 0.001) by SAP-2DE and from 47 ± 12 to 29 ± 10% (p < 0.001) by SAP-RNA. SAP-induced WMA or deterioration of previously diseased segments were detected in 92.8 % of the CAD patients by 2DE and in 71.4% by RNA. The overall sensitivity of the method was 87%; however, in those in whom SAP was successfuly completed, sensitivity and specificity of SAP-2DE in detecting CAD were 92.8 and 100%, respectively, by WMA criteria, while the sensitivity of RNA was 71.4%. According to EF criteria, the sensitivity of both 2DE and RNA was 92.8%. SAP-2DE was superior to SAP-RNA in localizing diseased vessels seen in coronary angiography. We conclude that SAP-2DE is a feasible and clinically applicable technique for the diagnosis of CAD and compares favorably with SAP-RNA. It is of particular value in patients who cannot perform dynamic exercise tests.

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Section: Discussionmentioning

confidence: 99%

“…Recently, Iliceto et al [12] reported 5% false-positive tests using trans esophageal pacing and 2DE imaging.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis of Coronary Artery Disease by Two-Dimensional Echocardiography versus Radionuclide Angiography during Stress Atrial Pacing

Abinader¹,

Hassan²,

Goldhamer³

et al. 1990

Am J Noninvas Cardiol

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“…A small number of test modalities including two studies of Dobutamine-TEE, three studies of oral Dipyridamole stress, and one study of Dipyridamole-TEE were also excluded because of paucity of data. Thus our final data set included 44 studies with exercise stress , 11 with adenosine [33,43,[52][53][54][55][56][57][58][59][60], 80 with dobutamine [29,34,36,48,51,56,58,, 40 with dipyrdamole [34,35,39,48,62,69,75,79,93,99,100,118,119,122,, 13 with Transatrialpacing (6 involving transesophageal [160][161][162][163][164][165] and 7 involving transthoracic echocardiography (Table 1) [16,35,[161][162][163][164][165][166][167][168][169]…”

Section: Overview Of Studiesmentioning

confidence: 99%

A meta-analytic comparison of echocardiographic stressors

Noguchi

Nagata-Kobayashi

Stahl

et al. 2005

Int J Cardiovasc Imaging

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Tap-TEE is a very accurate test for both ruling in and ruling out CAD although its invasiveness may limit its clinical acceptability. Exercise is a well-balanced satisfactory test for both ruling in and ruling out but performance might be lower for the elderly. Dobutamine offers a reasonable compromise for Exercise. Dipyridamole might be good for ruling in but not for ruling out CAD. The incapability in ruling-out CAD was a major problem in clinical application of the stress. Adenosine was the least useful stressor in diagnosing CAD.

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“…The premise underlying exercise echocardiography is that exercise will induce transient wall motion abnormalities associated with ischemia at the time of stress which are detectable with echocardiography. The stress employed can be either treadmill exercise testing [38][39][40][41][42], bicycle ergometry [43,44], pharmacologic stress [45] or atrial pacing [46,47]. More recently data acquired from our institution and others have used exercise echocardiography to assess prognosis following recovery from myocardial infarction.…”

Section: Exercise Echocardiographymentioning

confidence: 99%

Echocardiography and coronary artery disease: Current and future applications

Armstrong

1987

Int J Cardiac Imag

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Echocardiographic techniques are becoming more widespread for evaluating patients with known or suspected coronary artery disease. Because it affords an excellent overall view of the heart, two-dimensional echocardiography, rather than M-mode echocardiography, is the imaging procedure of choice when dealing with coronary artery disease. This technique can be used to make the initial diagnosis of acute myocardial infarction, diagnose complications, and assess prognosis following myocardial infarction. Additionally by combining this test with stress testing, latent coronary artery disease can be detected. Recovery of wall motion can be assessed following interventions such as thrombolysis or balloon angioplasty. Investigational and future uses include tissue characterization, which may allow detection of ischemic but potentially viable myocardium, direct coronary visualization for detection of atherosclerotic involvement of the proximal coronary arteries and myocardial contrast echocardiography. The latter technique allows visualization of perfusion by way of injecting contrast material into the coronary circulation. This has been demonstrated to be an accurate means of determining myocardial infarction size in an animal model and is currently being used in a number of centers in patients at the time of cardiac catheterization. In summary two-dimensional echocardiography currently allows assessment of patients with myocardial infarction from the time of their presentation through their convalescent period with respect to diagnosis, prognosis and presence of complications. Exercise echocardiography can diagnose latent coronary artery disease. The newer investigational techniques show promise for furthering our ability to evaluate patients with coronary artery disease using echocardiography.

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Comparison of postexercise and transesophageal atrial pacing two-dimensional echocardiography for detection of coronary artery disease

Cited by 65 publications

References 27 publications

Diagnosis of Coronary Artery Disease by Two-Dimensional Echocardiography versus Radionuclide Angiography during Stress Atrial Pacing

Diagnosis of Coronary Artery Disease by Two-Dimensional Echocardiography versus Radionuclide Angiography during Stress Atrial Pacing

A meta-analytic comparison of echocardiographic stressors

Echocardiography and coronary artery disease: Current and future applications

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