Transesophageal stress echocardiography: Detection of coronary artery disease in patients with normal resting left ventricular contractility

Zabalgoitia, Miguel; Gandhi, Dipeshkumar K.; Abi-Mansour, Pierre; Yarnold, Paul R.; Moushmoush, Bassam; Rosenblum, Joseph

doi:10.1016/0002-8703(91)90590-e

Cited by 25 publications

(4 citation statements)

References 10 publications

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“…The strengths of the test were the ability to obtain high‐quality echocardiographic images. The limitations of the TEE approach are limited visualization of the left ventricle in transgastric views, the time‐consuming nature of the test, and the need for expertise on the part of the operator and the assisting personnel 19 . While TEE in itself is a safe procedure, atrial pacing during TEE may be associated with a lack of atrial capture or patient intolerance in up to 20% of patients.…”

Section: Discussionmentioning

confidence: 99%

Atrial Pacing Stress Echocardiography: An Alternative Diagnostic Test for Chest Pain in the Elderly

Shenoy

Sengupta

Khanna

2002

American J Geri Cardiology

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The authors utilized rapid right atrial pacing and handgrip exercise to provoke myocardial ischemia in 20 participants (age >65 years) who, for reasons of disability, were not candidates for exercise and pharmacologic stress testing. Echocardiographic left ventricular ejection fraction and left ventricular wall motions were obtained during pacing at baseline and at maximal pacing rates and were compared with coronary angiography. Using the failure of left ventricular ejection fraction to increase with pacing as an indicator of myocardial ischemia, the test yielded a sensitivity of 75%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 71%. When a pacing‐induced decrease of wall‐motion index was taken as an ischemia indicator, the sensitivity was 63%, specificity 100%, positive predictive value 100%, and negative predictive value 80%. Rapid atrial pacing echocardiography is a safe test. It may be considered in a select group of elderly patients as an alternative to exercise or pharmacologic tests before resorting to coronary angiography.

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Section: Discussionmentioning

confidence: 99%

Atrial Pacing Stress Echocardiography: An Alternative Diagnostic Test for Chest Pain in the Elderly

Shenoy

Sengupta

Khanna

2002

American J Geri Cardiology

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“…Since TEE has proven a safe technique with only mild blood pressure increase during the procedure [4], it seems suited in combination with atrial stimulation to evaluate hemodynamic significance of coronary lesions in such patients. Several studies have confirmed that this combined technique is a highly specific and sensitive stress test (range 93-100% and 83-90%, respectively) to detect ischemia-induced wall motion abnormalities, the results of which compare well with those of exercise thallium scintigraphy and are superior to those of bicycle ergometry and pacing electrocardiography [5][6][7].…”

Section: Discussionmentioning

confidence: 99%

Simultaneous transesophageal echocardiography and atrial pacing: assessment of the functional significance of coronary artery disease before surgical treatment of an abdominal aneurysm

et al. 1994

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Conventional active stress tests for the evaluation of coronary artery disease are not feasible for patients in whom a significant blood pressure increase during a stress procedure should be avoided, for example, those with a coexisting aortic aneurysm. Transesophageal echocardiography (TEE) with simultaneous atrial pacing is a new, highly specific, and sensitive stress technique for the detection of coronary artery disease. Furthermore, TEE can be performed safely with only mild blood pressure increases. Therefore in the present case report of a 70-year-old male, application of combined TEE and atrial pacing was used successfully to exclude the hemodynamic significance of a circumflex artery stenosis and avoided a significant blood pressure increase before surgical correction of an abdominal aortic aneurysm.

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“…The sensitivity was 90% and the specificity was 93% (ref. 38). This study was limited by the use of short axis images only; these results may have been improved with more extensive evaluation of wall motion in other views.…”

Section: Reviews Intervention and Preventionmentioning

confidence: 99%

Choice of Imaging Modality in the Assessment of Coronary Artery Disease Risk in Extreme Obesity

Dunn

Huizinga

See

et al. 2010

Obesity

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Transesophageal stress echocardiography: Detection of coronary artery disease in patients with normal resting left ventricular contractility

Cited by 25 publications

References 10 publications

Atrial Pacing Stress Echocardiography: An Alternative Diagnostic Test for Chest Pain in the Elderly

Atrial Pacing Stress Echocardiography: An Alternative Diagnostic Test for Chest Pain in the Elderly

Simultaneous transesophageal echocardiography and atrial pacing: assessment of the functional significance of coronary artery disease before surgical treatment of an abdominal aneurysm

Choice of Imaging Modality in the Assessment of Coronary Artery Disease Risk in Extreme Obesity

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