Change in strain rate during dobutamine stress echocardiography detected ischemia with 89% sensitivity and 86% specificity compared to invasive fractional flow reserve.
Observational (n=30)
Does dobutamine stress echocardiography with strain rate imaging accurately detect ischaemia in patients with intermediate coronary lesions compared to invasive FFR?
Strain rate imaging during dobutamine stress echocardiography is a sensitive and specific non-invasive method for evaluating the haemodynamic significance of intermediate coronary lesions.
AIMS: The present study aims to compare the change of left ventricular deformation during dobutamine stress echocardiography (DSE) with the reference standard of invasive myocardial fractional flow reserve (FFR) to assess the haemodynamic significance of intermediate coronary lesions. METHODS AND RESULTS: In 30 patients with an intermediate coronary artery stenosis in one epicardial coronary artery, FFR measurements were performed during coronary catheterization. In case of an FFR or= 0.75, indicating normal flow reserve (non-ischaemic group). The remaining 17 patients with an FFR < 0.75 comprised the ischaemic group. At baseline DSE, mean values of strain rate (-1.2 +/- 0.3 s(-1)) and strain (-17 +/- 8%) were not significantly different between both groups. In the ischaemic group, in the target region, strain at peak stress decreased to - 10 +/- 8%, whereas strain rate remained unchanged. In contrast, in the non-ischaemic group, strain at peak stress remained unchanged (-18 +/- 7%), whereas strain rate increased to - 2.5 +/- 1.1 s(-1). The receiver operating characteristic curve analysis revealed the change in strain rate as the best parameter to detect ischaemia, with a sensitivity of 89% and a specificity of 86%. In the remote region, in both groups, strain rate (-1.4 +/- 0.4 s(-1)) and strain values (-20 +/- 7%) were not significantly different at baseline, and strain rate doubled and strain remained unchanged at DSE peak stress. CONCLUSION: Non-invasive evaluation of regional deformation, using strain rate imaging during DSE, predicted the relevance of intermediate coronary stenosis. In this context, strain rate is superior to strain measurements for the quantification of the contractile reserve.
Weidemann et al. (Thu,) conducted a observational in Intermediate coronary lesions (n=30). Dobutamine stress echocardiography (DSE) with strain rate imaging vs. Invasive myocardial fractional flow reserve (FFR) was evaluated on Detection of ischemia (FFR < 0.75) using change in strain rate. Change in strain rate during dobutamine stress echocardiography detected ischemia with 89% sensitivity and 86% specificity compared to invasive fractional flow reserve.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: