Dobutamine Stress Echocardiography with B-Mode Speckle Tracking in Patients after Acute Coronary Syndromes: Diagnostic and Prognostic Value

Autor: S. V. Potashev, S. V. Salo, A. Y. Gavrylyshyn, S. A. Rudenko, O. M. Holtvian
Jazyk: English<br />Russian<br />Ukrainian
Rok vydání: 2020
Předmět:
Zdroj: Український журнал серцево-судинної хірургії, Iss 3 (40), Pp 28-37 (2020)
Druh dokumentu: article
ISSN: 2664-5963
2664-5971
DOI: 10.30702/ujcvs/20.4009/031028-037
Popis: Background. Speckle tracking echocardiography (STE) provides valuable data on myocardial function. STE during dobutamine stress echocardiography (DSE) allows reliable myocardial ischemia diagnosis. Aim. To evaluate STE during DSE in patients with coronary artery disease (CAD) after acute coronary syndrome (ACS) and its accuracy in ischemia diagnosis, assessment of myocardial viability and coronary reserve. Methods. We examined 58 patients (55 [94,8 %] men and 3 [5,2 %] women) men) with CAD after ACS admitted to our Institute for defining indications for coronary interventions. All the patients underwent DSE with STE for longitudinal strain quantification. Results. Mean left ventricular ejection fraction (LVEF) was 52.4±5.8%. Significant CAD according to coronary angiography (CAG) prior to DSE was proved in 38 (65.5%) patients. All the patients had a history of ACS up to 12 years before the examination (38 [65.5%] patients after percutaneous coronary intervention (PCI), including 18 [31.0%] primary PCI; 9 [15.5%] patients after coronary artery bypass grafting (CABG); 3 [5.2%] after graft PCI, 1 [1.72%] patient after aortic valve replacement (AVR) with dilated cardiomyopathy (DCM) phenotype). There were no significant complications during DSE: 5 (8.6%) cases of relatively low grade transient arrhythmia with no need for intervention. As per DSE results, we performed 35 (60.3%) revascularization interventions: 31 (58.6%) PCI’s and 4 (6.9%) CABG procedures with good outcomes. It was shown that DSE with STE sensitivity and specificity were 89.7% and 94.7% (AUC 0.92), respectively, with positive and negative predictive values of 97.2% and 81.8%, respectively, with extremely high OR 157.5, p
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