Diagnostic models using quantitative stress echocardiography diagnosed coronary artery disease with sensitivities up to 93%, performing better than velocity cut-offs alone (p<0.001).
Observational (n=289)
Does quantitative stress echocardiography using tissue Doppler and multivariable diagnostic models improve the diagnostic accuracy for coronary artery disease compared to velocity cut-offs alone in patients referred with chest pain?
Quantitative stress echocardiography using tissue Doppler and multivariable diagnostic models significantly improves the non-invasive detection of coronary artery disease compared to simple velocity cut-offs.
p-value: p=<0.001
AIMS: To develop optimal methods for the objective non-invasive diagnosis of coronary artery disease, using myocardial Doppler velocities during dobutamine stress echocardiography. METHODS AND RESULTS: We acquired tissue Doppler digital data during dobutamine stress in 289 subjects, and measured myocardial responses by off-line analysis of 11 left ventricular segments. Diagnostic criteria developed by comparing 92 normal subjects with 48 patients with coronary disease were refined in a prospective series of 149 patients referred with chest pain. Optimal diagnostic accuracy was achieved by logistic regression models, using systolic velocities at maximal stress in 7 myocardial segments, adjusting for independent correlations directly with heart rate and inversely with age and female gender (all p<0.001). Best cut-points from receiver-operator curves diagnosed left anterior descending, circumflex and right coronary disease with sensitivities and specificities of 80% and 80%, 91% and 80%, and 93% and 82%, respectively. All models performed better than velocity cut-offs alone (p<0.001). CONCLUSION: Non-invasive diagnosis of coronary artery disease by quantitative stress echocardiography is best performed using diagnostic models based on segmental velocities at peak stress and adjusting for heart rate, and gender or age.
C MADLER (Mon,) conducted a observational in Coronary artery disease (n=289). Diagnostic models using off-line tissue Doppler during dobutamine stress echocardiography vs. Velocity cut-offs alone was evaluated on Diagnosis of left anterior descending, circumflex and right coronary disease (p=<0.001). Diagnostic models using quantitative stress echocardiography diagnosed coronary artery disease with sensitivities up to 93%, performing better than velocity cut-offs alone (p<0.001).