Abstract:
OBJECTIVE:The goal of this study was to determine whether wall stress at rest and during stress could explain the influence of left ventricular (LV) morphology on the accuracy of dobutamine stress echocardiography (DSE). BACKGROUND:The sensitivity of DSE appears to be reduced in patients with concentric remodeling, but the cause of this finding is unclear. METHODS:We studied 161 patients without resting wall motion abnormalities who underwent DSE and coronary angiography. Patients were classified into four groups according to relative wall thickness (normal <0.45) and LV mass (normal =131 g/m(2) in men and =100 g/m(2) in women): normal geometry, concentric remodeling, concentric hypertrophy, and eccentric hypertrophy. Significant coronary artery disease was defined as >/=50% stenosis. Circumferential (cESS) and meridional end-systolic wall stress (mESS) were calculated at rest and peak DSE. RESULTS:Both false-negative and false-positive results for DSE were present in 35 patients (22%). The accuracy of DSE in patients with concentric remodeling (61%) was lower than that in patients with normal geometry (85%, p < 0.05) or concentric hypertrophy (86%, p < 0.05), but the accuracy with eccentric hypertrophy (64%, p < 0.05) was lower than with concentric hypertrophy. Patients in lowest quartile of cESS and mESS at peak had significantly lower sensitivity and accuracy than those in the highest quartile. A reduced cESS at peak (p = 0.012), presence of concentric remodeling (p = 0.044), and eccentric hypertrophy (p = 0.012) were significant predictors of both false-negative and false-positive results for DSE. CONCLUSIONS:The accuracy of DSE is influenced by the LV geometric pattern and peak wall stress.
journal_name
J Am Coll Cardioljournal_title
Journal of the American College of Cardiologyauthors
Yuda S,Khoury V,Marwick THdoi
10.1016/s0735-1097(02)02105-8subject
Has Abstractpub_date
2002-10-02 00:00:00pages
1311-9issue
7eissn
0735-1097issn
1558-3597pii
S0735109702021058journal_volume
40pub_type
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journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
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abstract:BACKGROUND:A limitation of aspirin is that some patients, particularly those with diabetes, may not have an optimal antiplatelet effect. OBJECTIVES:The goal of this study was to determine if oral bioavailability mediates nonresponsiveness. METHODS:The rate and extent of serum thromboxane generation and aspirin pharma...
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doi:10.1016/0735-1097(95)00548-4
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abstract::Acquired immunodeficiency syndrome (AIDS) has become an increasingly important health problem worldwide. This review focuses on its cardiac complications. The key elements in the clinical syndrome are the opportunistic infections and the cancer that occur as a by-product of the immunodeficiency process. However, as ea...
journal_title:Journal of the American College of Cardiology
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更新日期:1995-06-01 00:00:00
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更新日期:2005-01-04 00:00:00
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更新日期:2018-07-17 00:00:00
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更新日期:2007-03-27 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
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更新日期:1984-02-01 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(83)80047-3
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更新日期:1993-10-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/j.jacc.2015.09.087
更新日期:2015-12-22 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
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更新日期:1993-06-01 00:00:00
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journal_title:Journal of the American College of Cardiology
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更新日期:2005-09-06 00:00:00
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journal_title:Journal of the American College of Cardiology
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更新日期:2005-02-15 00:00:00
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更新日期:2007-10-16 00:00:00
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journal_title:Journal of the American College of Cardiology
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doi:10.1016/0735-1097(94)90505-3
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更新日期:2016-03-29 00:00:00
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pub_type: 杂志文章
doi:10.1016/j.jacc.2004.09.060
更新日期:2005-01-18 00:00:00
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更新日期:2006-09-19 00:00:00
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更新日期:2010-12-07 00:00:00
abstract::For 40 years the American College of Cardiology has been a responsible organization in promoting the art and science of cardiac care for people of all ages. This review chronicles the leapfrogging of medical and surgical creativity and contributions to saving lives and making those lives healthy through informed care ...
journal_title:Journal of the American College of Cardiology
pub_type: 历史文章,杂志文章,评审
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更新日期:1989-06-01 00:00:00