scholarly journals 733 Left ventricular geometry is the major component of abnormal mid-ventricular gradients during negative dobutamine stress echocardiography

2003 ◽  
Vol 4 ◽  
pp. S94
Author(s):  
M CARRINHO ◽  
A MORAES ◽  
W PEREIRA ◽  
T XAVIER ◽  
M CASTIER ◽  
...  
Keyword(s):  
Stress Echocardiography ◽  
Dobutamine Stress Echocardiography ◽  
Dobutamine Stress ◽  
Left Ventricular ◽  
Left Ventricular Geometry ◽  
Ventricular Geometry

Abstract 2086: Usefulness of Pneumatic Lower Extremity Compression During Dobutamine Stress Echocardiography

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Hyung-Kwan Kim ◽  
Sung-A Chang ◽  
Jin-Shik Park ◽  
Yong-Jin Kim ◽  
Joo-Hee Zo ◽  
...  
Keyword(s):  
Coronary Angiography ◽  
Stress Echocardiography ◽  
Positive Response ◽  
Dobutamine Stress Echocardiography ◽  
False Negative ◽  
Lower Extremities ◽  
Wall Stress ◽  
Dobutamine Stress ◽  
Left Ventricular ◽  
Myocardial Oxygen Demand

Background Afterload is expected to increase with pneumatic compression of the lower extremities. Therefore, left ventricular (LV) wall stress which is the most important factor determining myocardial oxygen demand will also increase, leading to an increase in sensitivity of dobutamine stress echocardiography (DSE) or shortened time to positive response.The purpose of this study was to evaluate the effect of pneumatic compression of lower extremities on the diagnostic accuracy of DSE. Methods In 40 patients who underwent DSE and were anticipating coronary angiography, DSE was repeated with the pneumatic compression (100mmHg) of lower extremities (DSEcomp) prior to coronary angiography. Sensitivity and specificity of DSE and DSEcomp were determined based on the coronary angiographic finding. Results All patients tolerated pneumatic compression of the lower extremities during the tests. LV end-systolic volume (p=0.042) and end-systolic wall stress (p=0.036) were significantly greater in the DSEcomp than DSE. In 3 patients with false negative results in DSE, DSEcomp showed positive responses, demonstrating a significant increase in sensitivity from 75% to 94% (p=0.045). Only 1 patient with true negative result in DSE was interpreted as showing positive response in DSEcomp, resulting in a decrease in specificity from 88% to 83% (p=NS). In 11 of 13 patients with true positive results both in DSE and DSEcomp, positive responses were seen at least 1 stage earlier in DSEcomp compared to DSE. Conclusions Pneumatic compression of lower extremities increases the sensitivity of DSE and shortens the time to positive response.

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