The value of a simplified approach to end-systolic volume measurement for assessment of left ventricular contractile reserve during stress-echocardiography

The peak stress/rest ratio of left ventricular (LV) elastance, or LV force, is a load-independent index of left ventricular contractile reserve (LVCR) with stress echo (SE). To assess the accuracy of LVCR calculated during SE with approaches of different complexity. Two-hundred-forty patients were r...

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Bibliographic Details
Published in:The International Journal of Cardiovascular Imaging 2019-06, Vol.35 (6), p.1019-1026
Main Authors: Torres, Marco A. R., Texeira, Thais F., Camarozano, Ana C., Bellagamba, Clarissa C. A., Quevedo, Natalia M., Junior, Altair I. Heidemann, Bertoluci, Carolina, Bombardini, Tonino, De Nes, Michele, Ciampi, Quirino, Picano, Eugenio
Format: Article
Language:English
Subjects:
Blood pressure
Cardiac Imaging
Cardiology
Cardiovascular disease
Coronary artery
Coronary artery disease
Dipyridamole
Echocardiography
Feasibility studies
Females
Heart
Heart diseases
Imaging
Mathematical analysis
Medicine
Medicine & Public Health
Muscle contraction
Occupational health
Original Paper
Patients
Quality control
Radiology
Rest
Stress
Ventricle
Volume measurement
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Summary:The peak stress/rest ratio of left ventricular (LV) elastance, or LV force, is a load-independent index of left ventricular contractile reserve (LVCR) with stress echo (SE). To assess the accuracy of LVCR calculated during SE with approaches of different complexity. Two-hundred-forty patients were referred to SE for known or suspected coronary artery disease or heart failure and, of those, 200 patients, age 61 ± 15, 99 females, with interpretable volumetric SE were enrolled. All readers had passed the upstream quality control reading for regional wall motion abnormality (RWMA) and end-systolic volume (ESV) measurement. The employed stress was dipyridamole (0.84 mg, 6 min) in 86 (43%) and dobutamine (up to 40 mcg/kg/min) in 114 (57%) patients. All underwent SE with evaluation of RWMA and simultaneous LVCR assessment with stress/rest ratio of LV force (systolic blood pressure by cuff sphygmomanometer/ESV). ESV was calculated in each patient by two of three methods: biplane Simpson rule (S, in 100 patients), single plane area-length (AL, apical four-chamber area and length, in 100 patients), and Teichholz rule (T, from parasternal long axis and/or short axis view, in 200 patients). RMWA were observed in 54 patients. Success rate for ESV measurement was 76% (100/131) for S, 92% (100/109) for AL, and 100% (240/240) for T. There were 100 paired measurements (rest and stress) with S versus T, and 100 with AL versus T. The analysis time was the shortest for T (33 ± 8 s at rest, 34 ± 7 s at stress), intermediate for AL (70 ± 22 s at rest 67 ± 21 s at stress), and the longest for S (136 ± 24 at rest 129 ± 27 s at stress, p 
ISSN:1569-5794
1573-0743
1875-8312
DOI:10.1007/s10554-019-01599-5