Real-time three-dimensional dobutamine stress echocardiography in assessment of ischemia: Comparison with two-dimensional dobutamine stress echocardiography
Real-time three-dimensional dobutamine stress echocardiography in assessment of ischemia: Comparison with two-dimensional dobutamine stress echocardiography
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DOI：
10.1016/s0735-1097(01)01159-7
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发表时间：
2001-04-01
影响因子：
24
通讯作者：
Runge, M
中科院分区：
文献类型：
--
作者：
Ahmad, M;Xie, TR;Runge, M
本研究旨在测试使用实时三维超声心动图（RT-3D）检测多巴酚丁胺诱导的应激（DSE）期间缺血的可行性和有效性，并将结果与传统的二维超声心动图（2D）进行比较。方法279例连续的患者通过2D筛查fbr图像质量，253例图像质量良好的患者在基线和峰值DSE时在30 s内分别进行RT-3D和2D检查。结果实时三维超声心动图和2D在检测基线时左室壁运动异常方面具有良好的一致性（84%：Kappa = 0.59）和峰值DSE（88.9%：Kappa = 0.72）。两种技术在基线和DSE峰值时的左室壁运动评分相似。RT-3D在DSE峰值时检测缺血的观察者间一致性上级2D，分别为92.7%和84.6%（p < 0.05）。在50名随机选择的患者中，RT-3D在峰值应力下的平均扫描时间较短，为27.4 +/- 10.7 s，而2D为62.4 +/- 20.1 s（p < 0.0001）。在90例冠状动脉造影患者中，实时三维多巴酚丁胺负荷超声心动图诊断冠心病的敏感性为87.9%，而二维负荷超声心动图诊断冠心病的敏感性为79.3%。结论实时三维多巴酚丁胺负荷超声心动图诊断冠心病是可行的、敏感的。该手术提供了更短的扫描时间、上级观察者间的一致性和独特的LV新视图。（J Am Coil Cardiol 2001;37：1303-9）（C）美国心脏病学会2001年。
OBJECTIVES This study was designed to test the feasibility and efficacy of using real-time three-dimensional echocardiography (RT-3D) to detect ischemia during dobutamine-induced stress (DSE) and compares the results with conventional two-dimensional echocardiography (2D).BACKGROUND Real-time three-dimensional echocardiography, a novel imaging technique, offers rapid acquisition with multiple simultaneous views of the left ventricle (LV). These features make it attractive for application during stress.METHODS Of 279 consecutive patients screened fbr image quality by 2D, 253 patients with adequate images underwent RT-3D and 2D within 30 s of each other at baseline and at peak DSE.RESULTS Real-time three-dimensional echocardiography and 2D showed good concordance in detection of abnormal LV wall motion at baseline (84%: Kappa = 0.59) and at peak DSE (88.9%: Kappa = 0.72). Left ventricular wall motion scores were similar at baseline and peak DSE using both techniques. Interobserver agreements for detection of ischemia at peak DSE were superior for RT-3D, 92.7% compared with 84.6% for 2D (p < 0.05). Mean scanning time at peak stress by RT-3D in 50 randomly selected patients was shorter, 27.4 +/- 10.7 s compared with 62.4 +/- 20.1 s by 2D (p < 0.0001). In 90 patients with coronary angiograms, RT-3D had a sensitivity of 87.9% in the detection of coronary artery disease (CAD) compared with 79.3% by 2D.CONCLUSIONS Real-time three-dimensional dobutamine stress echocardiography is feasible and sensitive in the detection of CAD. The procedure offers shorter scanning time, superior interobserver agreements and unique new views of the LV. (J Am Coil Cardiol 2001;37:1303-9) (C) 2001 by the American College of Cardiology.