Squatting stress echocardiography potential in coronary heart disease diagnostics
https://doi.org/10.15829/1560-4071-2013-5-23-26
Abstract
While stress echocardiography (EchoCG) is widely used in clinical practice for diagnosing silent myocardial ischemia, the search for new stress tests remains an important task in the diagnostics of coronary heart disease (CHD).
Aim. To assess the potential of squatting stress EchoCG in the diagnostics of CHD.
Material and methods. In total, 53 men (mean age 53,2±0,93 years) underwent stress EchoCG. At coronary angiography, the CHD diagnosis was verified in 37 men (mean age 54,1±1,2 years), while in the other 16 men (mean age 51,0±1,4 years), myocardial ischemia was not confirmed. All participants underwent standard stress EchoCG with dobutamine, as well as supine and squatting EchoCG. The myocardial ischemia criterion was the development of additional asynergy zones in left ventricular myocardium.
Results. The test was performed in all patients, without any complications. Disturbed local contractility was observed at the time of squatting and rapidly disappeared while standing up. The sensitivity and specificity of squatting stress EchoCG in the CHD diagnostics were 94,6% and 81.3%, respectively.
Conclusion. Therefore, we have demonstrated a high diagnostic value of squatting stress EchoCG for diagnosing myocardial ischemia. This value was comparable to that of stress EchoCG with dobutamine.
About the Authors
V. A. KuznetsovRussian Federation
D. V. Krinochkin
Russian Federation
A. N. Premindra Chandraratna
United States
Yu A. Pak
Russian Federation
A. V. Plusnin
Russian Federation
E. A. Gorbatenko
Russian Federation
References
1. Clinical guidelines for ultrasound diagnostics. Vol. 5 / Edited by Mitkov V. V., Sandrikov V. A. Moscow: Vidar, 1998; 360. Russian (Клиническое руководство по ультразвуковой диагностике. V том/ Под ред. В. В. Митькова, В. А. Сандрикова М.: Видар, 1998. 360 с).
2. Shalnova S. A., Deev A. D., Oganov R. G. Factors influencing the mortality from cardiovascular disease in Russian population. Cardiovascular Therapy and Prevention. 2005; 4 (1): 4–8. Russian (Шальнова С. А., Деев А. Д., Оганов Р. Г. Факторы, влияющие на смертность от сердечнососудистых заболеваний в российской популяции. Кардиоваскулярная терапия и профилактика. 2005; 4 (1), c. 4–8).
3. Schiller N., Osipov M. A. Clinical Echocardiography, 2nd Edition. Moscow: Practice. 2005; 344. Russian (Шиллер Н., Осипов М. А. Клиническая эхокардиография. 2-е изд. М.: Практика. 2005. 344 с).
4. Coronary artery disease: diagnostic and prognostic models for reducing patient risk. J. Cardiovasc. Nurs. 2006 Nov-Dec;21 (6 Suppl 1): S2–16; quiz S17–9.
5. The European Society of Cardiology (ESC) guidelines for percutaneous coronary interventions (PCI). Herz. 2006 Dec; 31 (9):836–46, 848.
6. ACC/AHA Guidelines for Exercise Testing: Executive Summary. A Report of the American College of Cardiology/ American Heart Association Task Force on Practice Guidelines. Circulation.1997; 96:345–54.
7. The EAE Textbook of Echocardiography. Galiuto L., Badana L., Fox K., et al. Oxford University Press Inc., New York, 2011; 477.
8. American Society of Echocardiography Recommendations for Performance, Interpretation and Application of Stress Echocardiography. J Am Soc Echocardiogr. 2007; Vol 20:1023–41.
9. Chandraratna PA, Mohar DS, Sidarous PF, et. al. Implications of Acute Left Ventricular Remodeling during Squatting Stress Echocardiography. Echocardiography. 2012 Jul; 29 (6):700–5.
10. Chandraratna P, Kuznetsov V, Mohar D, et. al. Comparison of squatting stress echocardiography and dobutamin stress echocardiography for the diagnosis of coronary artery disease. Echocardiography. 2012 Jul; 29 (6):695–9.
11. Voigt J. U., Nixdorff U., Bogdan R., et. al. Comparison of deformation imaging and velocity imaging for detecting regional inducible ischaemia during dobutamine stress echocardiography. Eur Heart J 2004; 25: 1517–25.
12. Hanekom L., Cho Goo-Yeong, Leano R., et al. Comparison of two-dimensional speckle and tissue Doppler strain measurement during dobutamine stress echocardiography: an angiographic correlation. European Heart Journal. 2007; 28:1765–72.
13. Brian D. Strain and Strain Rate Echocardiography and Coronary Artery Disease. Circulation: Cardiovascular Imaging. 2011; 4: 179–90.
14. Geyer H, Caracciolo G, Abe H, et al., Assessment of myocardial mechanics using speckle tracking echocardiography: fundamentals and clinical applications. J Am Soc Echocardiogr. 2010; 23:351–69.
Review
For citations:
Kuznetsov V.A., Krinochkin D.V., Premindra Chandraratna A.N., Pak Yu.A., Plusnin A.V., Gorbatenko E.A. Squatting stress echocardiography potential in coronary heart disease diagnostics. Russian Journal of Cardiology. 2013;(5):23-26. (In Russ.) https://doi.org/10.15829/1560-4071-2013-5-23-26