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March 24, 2010Cardiovascular Ultrasound11 citationsOpen Access

Feasibility of real-time three-dimensional stress echocardiography: pharmacological and semi-supine exercise

LPLorenza PrataliSMSabrina MolinaroACAnca Irina Corciu

Key Result

Real-time three-dimensional stress echocardiography had an overall feasibility of 67%, which was significantly higher for pharmacological stress (80%) compared to exercise stress (51%).

Study Design

Type

Cross-Sectional (n=111)

Blinding

Single-blind

Multicenter

No

Structured PICO

Does real-time three-dimensional stress echocardiography provide feasible and reproducible evaluation of left ventricular function compared to 2D stress echocardiography in patients with known or suspected coronary artery disease?

P
Population
111 patients with known or suspected coronary artery disease undergoing stress echocardiography to assess the feasibility and reproducibility of real-time 3D imaging.
I
Intervention
Real-time three-dimensional stress echocardiography (RT3DSE) (exercise and pharmacological)
C
Comparator
2D stress echocardiography
O
Outcome
Feasibility and reproducibility of RT3DSE in the evaluation of left ventricular function (WMSI, EDV, ESV)surrogate

Real-time 3D stress echocardiography is feasible but more vulnerable to tachycardia and suboptimal image quality than 2D echocardiography, making pharmacological stress preferable to exercise for RT3D.

Limitations

  • Low frame rates of RT3D scanners compared to conventional 2D scanners.
  • High heart rates at peak stress significantly reduced the reproducibility of wall motion analysis.
  • Patient decubitus (semi-supine) during exercise stress negatively impacted image acquisition.

Abstract

BACKGROUND: Real time three dimensional (RT3D) echocardiography is an accurate and reproducible method for assessing left ventricular shape and function. AIM: assess the feasibility and reproducibility of RT3D stress echocardiography (SE) (exercise and pharmacological) in the evaluation of left ventricular function compared to 2D. METHODS AND RESULTS: One hundred eleven patients with known or suspected coronary artery disease underwent 2D and RT3DSE. The agreement in WMSI, EDV, ESV measurements was made off-line.The feasibility of RT-3DSE was 67%. The inter-observer variability for WMSI by RT3D echo was higher during exercise and with suboptimal quality images (good: k = 0.88; bad: k = 0.69); and with high heart rate both for pharmacological (HR or = 100 bpm, k = 0.49) and exercise SE (HR or = 120 bpm, k = 0.78). The RT3D reproducibility was high for ESV volumes (0.3 +/- 14 ml; CI 95%: -27 to 27 ml; p = n.s.). CONCLUSIONS: RT3DSE is more vulnerable than 2D due to tachycardia, signal quality, patient decubitus and suboptimal resting image quality, making exercise RT3DSE less attractive than pharmacological stress.

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Cite This Study

Pratali et al. (2010) conducted a cross-sectional in Known or suspected coronary artery disease (n=111). Real-time three-dimensional (RT3D) stress echocardiography vs. 2D stress echocardiography was evaluated on Feasibility of RT3D stress echocardiography. Real-time three-dimensional stress echocardiography had an overall feasibility of 67%, which was significantly higher for pharmacological stress (80%) compared to exercise stress (51%).

synapsesocial.com/papers/6a9150baca59a4cbdea15c21https://doi.org/10.1186/1476-7120-8-10
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