Strain rate imaging (AUC 0.95) was significantly more accurate than tissue velocity imaging (AUC 0.77) for detecting regional ischaemia during dobutamine stress echocardiography (p<0.0001).
Cross-Sectional (n=44)
Does strain rate imaging improve the diagnostic accuracy for detecting stress-induced ischaemia compared to tissue velocity imaging during dobutamine stress echocardiography in patients with known or suspected coronary artery disease?
Strain rate imaging provides significantly higher diagnostic accuracy than tissue velocity imaging for detecting regional ischaemia during dobutamine stress echocardiography, comparable to conventional reading.
Absolute Event Rate: 0.95% vs 0.77%
p-value: p=< 0.0001
AIMS: To determine whether Doppler based myocardial tissue velocity imaging (TVI) or strain rate imaging (SRI) is more accurate in detecting stress-induced ischaemia during dobutamine stress echocardiography (DSE). METHODS AND RESULTS: Regional myocardial velocity, displacement, strain rate and strain patterns during DSE were investigated in 44 routine patients with known or suspected coronary artery disease. Simultaneous perfusion scintigraphy defined regional ischaemia. Curves and curved-M-mode patterns were analysed and receiver-operating-characteristics of TVI and SRI parameters were compared by their area under the curve (AUC) in the receiver-operating-characteristics. In non-ischaemic segments, peak systolic velocity and strain rate increased significantly. Unlike SRI, TVI parameters had higher values in basal than in apical segments. In 47 segments of 19 segments DSE-induced ischaemia, which was proven by scintigraphy. In ischaemia, velocity and strain rate increased less. Post-systolic shortening (PSS) was always seen in SRI but not regularly in TVI. Peak systolic velocity and systolic displacement were the best TVI-parameters of stress-induced ischaemia (AUC 0.68 and 0.77, respectively.), in SRI it was the ratio of PSS and maximal segmental deformation (AUC=0.95, p < 0.0001). CONCLUSION: Compared to TVI, SRI parameters showed no major apico-basal gradient and had significantly higher diagnostic accuracy, comparable to conventional reading. SRI thus appears superior to TVI for regional ischaemia detection during DSE and may be preferred to support conventional DSE reading.
Jens‐Uwe Voigt (Wed,) conducted a cross-sectional in Known or suspected coronary artery disease (n=44). Strain rate imaging (SRI) vs. Myocardial tissue velocity imaging (TVI) was evaluated on Diagnostic accuracy for detecting stress-induced ischaemia (Area Under the Curve) (p=< 0.0001). Strain rate imaging (AUC 0.95) was significantly more accurate than tissue velocity imaging (AUC 0.77) for detecting regional ischaemia during dobutamine stress echocardiography (p<0.0001).