Key result
Left ventricular wall motion abnormality blunted the early diastolic filling response to dobutamine stress echocardiography, resulting in significantly lower peak E-wave velocities compared to normal subjects.
Why the study?
Does left ventricular wall motion abnormality affect global and regional diastolic function of the left and right ventricles at rest and after dobutamine stress?
Observational (n=59)
No
Does left ventricular wall motion abnormality affect global and regional diastolic function of the left and right ventricles at rest and after dobutamine stress?
Left ventricular wall motion abnormalities blunt the early diastolic filling reserve of the left ventricle during dobutamine stress, while right ventricular diastolic function remains unaffected.
LV wall motion abnormalities may blunt diastolic filling reserve on dobutamine stress echo; leaves open prognostic implications and need for prospective validation.
BACKGROUND: Diastolic dysfunction precedes systolic dysfunction in patients with coronary artery disease. The aim of the study was to evaluate the effects of left ventricular (LV) wall motion abnormality (WMA) on diastolic LV and right ventricular (RV) function at rest and after stress. METHODS: Fifty-nine subjects, 15 with LV-WMA (abnormal group) and 44 without (normal group), underwent dobutamine stress echocardiography (DSE) studies, in addition to evaluation of LV and RV diastolic function before and after DSE. RESULTS: Resting mitral flow parameters were similar. DSE increased peak A-wave velocities in both groups, and mitral color slope only in normal subjects. After DSE, E-wave peak velocities and mitral color slope were higher in normal subjects, P < 0.05. At rest and after DSE systolic and diastolic pulmonary vein velocities were similar in both groups; however, DSE increased these velocities only in normal subjects, P < 0.05. Regional E-wave peak velocities of LV were higher at rest in normal subjects, P < 0.05. Both LV and RV, regional peak E-wave velocities were not affected by DSE. After DSE, regional A-wave peak velocities increased in all (P < 0.01), except at the lateral region (P = 0.07). DSE increased trans-tricuspid velocities in both groups, P < 0.05. Resting A-wave velocities were higher in normal subjects, P < 0.01. CONCLUSIONS: Global LV early diastolic filling parameters were not affected by LV-WMA at rest. LV-WMA blunted the response after stress. RV E-wave velocities increased after DSE, and were not affected by LV-WMA. LV-WMA reduced regional LV-E' velocities at rest but not the reserve. A-wave velocities were not affected by WMA and increased after DSE.
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Sharif et al. (2014) conducted an observational in Suspected coronary artery disease (n=59). Left ventricular wall motion abnormality vs. No left ventricular wall motion abnormality was evaluated on Peak early diastolic mitral E-wave velocity after dobutamine stress echocardiography (p=0.0014). Left ventricular wall motion abnormality blunted the early diastolic filling response to dobutamine stress echocardiography, resulting in significantly lower peak E-wave velocities compared to normal subjects.
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