Systolic longitudinal strain correlates with visual assessment of regional left ventricular function during dobutamine stress echocardiography and discriminates the segments with induced contractility impairment

Wierzbowska−Drabik, Karina; Miśkowiec, Dawid; Kasprzak, Jarosław D.

doi:10.1111/echo.13582

Echocardiography

2017

DOI: 10.1111/echo.13582

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Systolic longitudinal strain correlates with visual assessment of regional left ventricular function during dobutamine stress echocardiography and discriminates the segments with induced contractility impairment

Karina Wierzbowska−Drabik

Dawid Miśkowiec

Jarosław D. Kasprzak

Abstract: Strain analysis quantifies segmental LV contractility not only at rest and peak DSE but may be helpful in detection of stress-induced contractility worsening.

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Cited by 3 publications

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“…15 Cardiac rotation around the long axis represents an important component of LV global systolic function. 16,17 Data concerning the significance of novel parameters of LV function are limited, especially in the DSE setting.…”

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confidence: 99%

Quantitative assessment of the rotation and twist of the left ventricle during dobutamine stress echocardiography: a comparison of patients with and without significant coronary artery disease

et al. 2019

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BACKGROUND The rotation and twist of the left ventricle (LV) have been comprehensively evaluated at rest. However, little is known about rotational mechanics during dobutamine stress echocardiography (DSE). AIMS We aimed to quantify and compare the basal and apical rotation and twist of the LV at rest as well as at the peak and recovery stages of DSE in patients with and without coronary artery disease (CAD). METHODS We enrolled 91 patients, including 48 patients with CAD and 43 patients without CAD (mean [SD] age, 62 [9] years and 61 [10] years, respectively). Coronary artery disease was defined as the presence of stenoses of 50% or more in the left main coronary artery and/or stenoses of 70% or more in other epicardial arteries. Rotation was measured by 2-dimensional speckle-tracking echocardiography, and twist was calculated as the difference between the basal and apical rotation. RESULTS Neither rotation nor twist differed between patients with and without CAD at rest, although apical rotation was significantly greater in the CAD group at peak DSE (mean [SD], 5.43° [3.45°] vs 3.71° [3.52°], P = 0.01) and at recovery (mean [SD], 5.05° [3.65°] vs 2.87° [2.73°], P <0.01). On the contrary, the absolute value for basal rotation at recovery was higher in patients without CAD (mean [SD], 3.87° [3.37°] vs 2.63° [2.43°], P = 0.03). In both groups, the rotation and twist did not change significantly during the dobutamine challenge. CONCLUSIONS During DSE, we observed differences in LV rotation between patients with and without CAD, revealing the effect of ischemia on deformation parameters.

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confidence: 99%

Quantitative assessment of the rotation and twist of the left ventricle during dobutamine stress echocardiography: a comparison of patients with and without significant coronary artery disease

et al. 2019

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Early ischemia identification employing 2D speckle tracking selective layers analysis during dobutamine stress echocardiography

et al. 2019

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PurposeTwo‐dimensional (2D) strain derived from speckle tracking proved to be feasible and accurate in the quantitative evaluation of myocardial ischemia during stress echocardiography. We compared the accuracy in detecting myocardial ischemia of the transmural segmental analysis with an endocardial specific evaluation in 20 patients undergoing dobutamine stress echocardiography (DSE) and coronary angiography.MethodsPeak systolic global strain (G‐ε) and at the subendocardial level (Endo‐ε) were measured off‐line at rest, a low dose, and peak stress; then, we compared the results with wall‐motion analysis and significant coronary artery disease (CAD > 70% diameter stenosis). Endocardial strain variation from basal to low and peak dose was computed both for global or subendocardial analysis. The utilization of the ROC curve allowed us to derive optimal cutoffs, sensibility and specificity for ischemic segments.ResultsThe subendocardial analysis at high dose showed to be able to increase significantly the accuracy of the test to detect the ischemic segments (sens 90.2% vs 85.4%; spec 93.1% vs 92.2%). Moreover, at the low dose, the subendocardial analysis showed to be able to increase significantly, mostly the specificity of the test (sens 69.6% vs 68.3%; spec 92.2% vs 86.2%). Notably, the strain subendocardial analysis at low dose showed to reach a high specificity, similar to the peak dose transmural analysis.ConclusionsMeasurement of subendocardial strain during DSE is feasible and can increase the accuracy of the test. Moreover, the subendocardial strain during DSE can reach a high specificity, even limiting the test at a low dose infusion.

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Comparison between Visual Assessment and Longitudinal Strain during Dobutamine Stress Echocardiography

Karolina,

Soesanto,

Kuncoro

et al. 2023

Journal of Cardiovascular Echography

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Background: The relationship between visual assessment and longitudinal strain during dobutamine stress echocardiography (DSE) remains poorly investigated. This study assessed wall motion segments visually graded as normokinetic, hypokinetic, and akinetic at baseline and the peak of DSE and compared with longitudinal strain between segments with and without induced impaired contractility and improved contractility during DSE. Methods: This study included 112 patients examined by DSE, consisting of 58 patients referred for diagnostic study and 54 patients referred for viability study. Regional left ventricular (LV) contractility was assessed visually and longitudinal strain was measured using echocardiography transthoracic. Results: At baseline, the strain of LV segments was −16.33 ± 6.26 in visually normokinetic, 13.05 ± 6.44 in visually hypokinetic, and −8.46 ± 5.69 in visually akinetic segments. During peak dose, the strain of LV segments was −15.37 ± 6.89 in visually normokinetic, −11.37 ± 5.11 in visually hypokinetic, and −7.37 ± 3.92 in visually akinetic segments. In segments with visually observed impaired contractility, the median longitudinal strain was significantly lower than in segments without impaired contractility. For segments with visually observed improved contractility, the median longitudinal strain was significantly higher than for segments without improved contractility. In diagnostic study, sensitivity of visual assessment for absolute decrease of >2% longitudinal strain was 77%, respectively. In the viability study, the sensitivity was 82% for an absolute decrease of ≥2% longitudinal strain. Conclusions: There is good association between strain analysis value and visually assessed wall motion contractility.

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Systolic longitudinal strain correlates with visual assessment of regional left ventricular function during dobutamine stress echocardiography and discriminates the segments with induced contractility impairment

Abstract: Strain analysis quantifies segmental LV contractility not only at rest and peak DSE but may be helpful in detection of stress-induced contractility worsening.

Cited by 3 publications

References 27 publications

Quantitative assessment of the rotation and twist of the left ventricle during dobutamine stress echocardiography: a comparison of patients with and without significant coronary artery disease

Quantitative assessment of the rotation and twist of the left ventricle during dobutamine stress echocardiography: a comparison of patients with and without significant coronary artery disease

Early ischemia identification employing 2D speckle tracking selective layers analysis during dobutamine stress echocardiography

Comparison between Visual Assessment and Longitudinal Strain during Dobutamine Stress Echocardiography

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