scholarly journals Detection of symptom-related coronary arteries in patients with coronary artery disease using real-time three-dimensional stress echocardiography with adenosine triphosphate

2021 ◽  
pp. 26-32
Author(s):  
N. J. Nelasov ◽  
A. V. Pomortsev ◽  
E. A. Arzumanjan ◽  
O. L. Eroshenko ◽  
M. N. Morgunov ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Arteries ◽  
Healthy Subjects ◽  
Stress Test ◽  
Three Dimensional ◽  
Visual Assessment ◽  
Left Ventricular ◽  
Normative Values ◽  
Stress Echo ◽  
Artery Disease

Aim 1) To develop normative values of global and regional left ventricular longitudinal deformation (LVLD) during real time three-dimensional stress echocardiography with adenosine triphosphate (ATP) and utilization of automated function imaging technology (4D Stress-Echo + LVLD with ATP); 2) to compare the effectiveness of detection of symptom-related coronary arteries during 4D Stress-Echo with ATP using: a) traditional visual assessment of regional myocardial contractility and b) step-by-step analysis of segmental LVLD.Material and Methods 15 healthy subjects and 32 patients with coronary artery disease (CAD) were examined after coronary angiography. All individuals underwent 4D Stress-Echo + LVLD with ATP (Vivid E95, General Electric).Results The normative values of global LVLD at three stages of the pharmacological stress-test (before, during and after ATP infusion) were –19.5 (95% CI: -20.4 – -19.0), –21.6 (95% CI: -22.8 – -20.4) and –19.5 (95% CI: -20.3 – -18.6), respectively; the values of LVLD in each of the 17 segments of left ventricular myocardium in healthy subjects were also determined. In patients with CAD visual control of contractility during stress test revealed dynamic decrease in local thickening of the myocardium, appearance of new zones of contractility disorders and expansion of previously noted in 31.2% of cases, while analysis of deformation detected the appearance of new zones of deformation disturbances and expansion of previously found – in 68.7% (р = 0.0055). Stress-induced worsening of myocardial deformation during ATP infusion in the zones of blood supply of left anterior descending coronary artery, circumflex artery and right coronary artery (with presence of hemodynamically significant stenoses and occlusions detected during coronary angiography) were found in 28.0, 77.7 and 65.2% respectively (р1-3 = 0.0194; р1-2 = 0.0019; р2-3 = 0.2864).Conclusion The normal values of global and segmental LVLD for each stage of 4D Stress-Echo + LVLD with ATP were determined. 4D Stress-Echo + LVLD with ATP can significantly increase the effectiveness of symptom-related coronary arteries identification in patients with CAD in comparison with traditional Stress-Echo with visual assessment of local myocardial contractility.

scholarly journals P1550 Detection of symptom related coronary arteries in patients with coronary artery disease by 4D stress echo with adenosine triphosphate

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
N Nelassov ◽  
M Morgunov ◽  
N Doltmurzieva ◽  
R Sidorov ◽  
E Arzumanjan ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Adenosine Triphosphate ◽  
Coronary Arteries ◽  
Visual Analysis ◽  
Stress Test ◽  
Dose Increase ◽  
Visual Evaluation ◽  
Stress Echo ◽  
Artery Disease

Abstract Background In previous publications, we have proposed new algorithm of pharmacologic Stress Echo with possibility of stepwise adenosine triphosphate (ATP) i/v dose increase (Figure 1). Purpose In this study we decided to compare the effectiveness of detection of symptom related coronary arteries in patients with coronary artery disease (CAD) by ATP 4D Stress Echo of left ventricle (LV) and a) traditional visual evaluation of LV segmental hypokinesis b) Automatic Function Imaging (AFI) technology longitudinal LV strain (LS) analysis. Material and methods. 26 patients with CAD (male 24, mean age 63.1 ± 7.5 years, single vessel obstructive disease 7, multivessel - 19) underwent ATP LV 4D Stress Echo (Vivid E95, GE). Number of cases when it was possible to detect symptom related arteries by visual analysis of LV segmental hypokinesis and by AFI LV LS analysis were compared. Results In 11 (42.3%) patients expansion of existing hypokinetic areas and appearance of new LV segments with hypokinesis during stress test were detected by visual analysis. Using AFI technology expansion of initial areas of LS disturbances and appearance of new LV segments with LS disturbances were found in 21 (80,7%) patients (р=0.0044). Conclusion Utilization of AFI LV LS analysis during ATP LV 4D Stress Echo significantly increases the frequency of symptom related coronary arteries detection in patients with CAD. Abstract P1550 Figure1

Prognostic Value of Exercise Stress Test and Dobutamine Stress Echo in Patients with Known Coronary Artery Disease

2009 ◽  
Vol 26 (1) ◽  
pp. 1-9 ◽  
Author(s):  
Francesca Innocenti ◽  
Francesca Caldi ◽  
Irene Tassinari ◽  
Chiara Agresti ◽  
Costanza Burgisser ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Prognostic Value ◽  
Stress Test ◽  
Exercise Stress Test ◽  
Dobutamine Stress ◽  
Exercise Stress ◽  
Stress Echo ◽  
Artery Disease

scholarly journals Three-dimensional speckle tracking echocardiography in evaluating left ventricular function in patients with triple vessel coronary artery disease

2021 ◽  
Author(s):  
Xiuxiu Cui ◽  
Huaying Bo ◽  
Yu Dong ◽  
Ying Wang ◽  
wenxing chang ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Three Dimensional ◽  
Left Ventricular ◽  
Lv Function ◽  
Vessel Coronary Artery Disease ◽  
Stenosis Rate ◽  
Artery Disease ◽  
Vessel Coronary Artery

AIM Using three-dimensional ultrasound speckle tracking echocardiography (3D-STE) to evaluate left ventricular (LV) function in patients with triple vessel coronary artery disease(TVD) without myocardial infarction. METHODS Sixty patients with TVD without myocardial infarction were divided into two groups according to the results of coronary angiography. Group B (n=31)：50%≤the stenosis rate of all triple vessel coronary artery＜75%; Group C (n=29)：the stenosis rate of all triple vessel coronary artery≥75%. Thirty healthy subjects were recruited as the group A. We measured LV end-diastolic and end-systolic volume (LVEDV, LVESV) and LV ejection fraction (LVEF) using real-time dynamic three-dimensional echocardiography. The 3D-STE parameters of LV included global longitudinal strain (GLS), global area strain (GAS), global radial strain (GRS) and global circumferential strain (GCS). The correlation between 3D-STE parameters and NT-proBNP were analyzed by Pearson linear correlation analysis. RESULTS In group C, LVEDV and LVESV were significantly increased (all P＜0.05), while LVEF, GLS, GRS, GCS and GAS were significantly decreased compared with groups A and B (all P＜0.05). In groups A and B, there were no statistical differences in LVEDV, LVESV and LVEF. However, GLS, GCS and GAS were lower in group B than in group A (all P＜0.05). The correlation analysis showed a negative correlation between the absolute values of GLS, GRS, GCS, GAS and NT-proBNP in group C (r=-0.866、-0.587、-0.428、-0.600，P＜0.001、P=0.001、P=0.020、P=0.010). CONCLUSIONS Our study shows that 3D-STE can evaluate the LV function in patients with triple vessel coronary artery disease without myocardial infarction through multiple strain parameters.

scholarly journals Myocardial Infarction with Non-Obstructive Coronary Artery Disease: The Labyrinth of Investigations. Case Report and Review of the Literature

Life ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. 1181
Author(s):  
Paul Simion ◽  
Bogdan Artene ◽  
Ionut Achiței ◽  
Iulian Theodor Matei ◽  
Antoniu Octavian Petriș ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Arteries ◽  
Obstructive Coronary Artery Disease ◽  
Left Ventricular ◽  
Myocardial Infarctions ◽  
Left Ventricular Ejection ◽  
Emergency Setting ◽  
Artery Disease

Myocardial infarction with non-obstructive coronary artery disease (MINOCA) accounts for approximately 5–15% of acute myocardial infarctions (MI). This infarction type raises a series of questions about the underlying mechanism of myocardial damage, the diagnostic pathway, optimal therapy, and the outcomes of these patients when compared to MI associated with obstructive coronary artery disease. We present the case of a 60-year-old patient with multiple cardiovascular risk factors and comorbidities who is admitted in an emergency setting. The patient is known with a conservatively treated inferior myocardial infarction which occurred 3 months prior, with reduced left ventricular ejection fraction. Emergency coronary angiography revealed normal epicardial coronary arteries, which led to further investigations of the underlying cause. Considering the absence of epicardial and microvascular spasm, CMR (cardiac magnetic resonance) confirmation of two transmural myocardial infarctions in the territories tributary to coronary arteries, and a high index of myocardial resistance in culprit arteries, we concluded the diagnosis of MINOCA due to the microvascular endothelial dysfunction. Although the concept of MINOCA was devised almost a decade ago, and these patients are an important part of MI presentations, it still represents a diagnostic challenge with multiple explorations required to establish the precise etiology.

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