Views
9
Downloands
3
Amaç: Bu çalışma, dobutaminli atım dalgalı doku Doppler ekokardiyografinin, is- kemik ve iskemik olmayan miyokardiyal segmentlerin ayrımında kullanılabilirliğini araştırmak için yapıldı. Gereç ve Yöntemler: Çalışma, istirahat ekokardiyografilerinde sol ventrikül seg- menter kinezi bozukluğu olmayan ve klinik olarak koroner anjiyografi endikasyo- nu konulan 18 hasta (yaş ortalaması 56.4±7.7; 7 kadın, 11 erkek) üzerinde yapıldı. Hastalar kateterizasyondan önceki 24 saat içinde ekokardiyografi laboratuvarına alındı. Apikal aküstik pencereler kullanılarak dinlenme ve pik dobutamin infüzyo- nu sırasında, mitral anülüs, bazal ve orta segmentlerden sistolik doku hızları elde edildi. Ölçülen hızlar kullanılarak dobutamin pik infüzyonu sırasındaki sistolik hızın istirahat ölçümüne göre artış yüzdesi (S%) hesaplandı. Koroner arter hastalığı en az bir majör epikardiyal arterde %50 veya daha fazla stenoz olması olarak tanımlandı. Miyokardiyal segmentler 3 gruba ayrıldı. Koroner anjiyografisi normal olan kim- selere ait segmentler Grup 1 sayıldı. Koroner arter hastalığı olanların segmentleri, normal koroner tarafından kanlanıyorsa Grup 2, stenoz olan koroner arter tarafından kanlanıyorsa Grup 3 olarak sınıflandırıldı. Bulgular: Çalışmamızda S% Grup 1’de 79.0±39.2, Grup 2’de 76.1±25.3, Grup 3’de 49.2±23.1 olarak bulundu (F=19.175, p<0.001). Farklılık Grup 3’ün diğerlerinden daha düşük olmasından kaynaklanıyordu (p<0.001). ROC analizi yardımı ile S%’in %59’un altında olmasının iskemik segmentleri %75 sensitivite ve %75 spesifisite ile predikte ettirdiği gösterildi. Sonuç: Sol ventrikül segmenter kinezi bozukluğu olmayan hastalarda, dobutaminli doku Doppler ekokardiyografi ile elde edilen S%, iskemik segmentleri iskemik ol- mayanlardan ayırmakta faydalı olabilir. Anahtar kelimeler: Dobutaminli Stres Ekokardiyografi, Atım Dalgalı Doku Dopp- ler Ekokardiyografi, İskemi ASSESSMENT OF MYOCARDIAL ISCHEMIA USING DOBUTAMINE STRESS PULSED- WAVE TISSUE DOPPLER ECHOCARDIOGRAPHYABSTRACT Objective: To evaluate the utility of dobutamine stress pulsed-wave tissue Dopp- ler echocardiography in differentiating ischemic myocardial segments from non- ischemic ones. Materials and Methods: Eighteen patients (mean age 56.4±7.7, 11 male) who had normal left ventricular regional wall motion analysis at rest and undergoing coronary angiography for clinical reasons were included. In each subject, mitral annular, basal, and mid-segment systolic velocities was obtained from the apical echocardiographic windows at rest and during peak dobutamine infusion. Two systolic velocity measu- rements were used to calculate the percent increase in systolic velocity (S%) during peak dobutamine infusion relative to rest measurements. Coronary artery disease was defined as ≥50 percent stenosis in at least one major epicardial coronary ar- tery. The myocardial segments were classified into 3 groups. The cardiac segments belonging to patients with normal coronary angiograms were Group 1. The cardiac segments belonging to patients with coronary artery disease were classified as Gro- up 2 if the segment was supplied by a normal coronary artery or Group 3 if it was supplied by a stenosed artery. Results: S% values in Groups 1, 2, and 3 were 79.0±39.2, 76.1±25.3, and 49.2±23, respectively (F=19.175, p<0.001). S% values in Group 3 were lower than those in both Groups 1 and 2 (p<0.001). Based on ROC analysis, S% less than 59% predicts ischemic segments with a sensitivity of 75% and a specificity of 75%. Conclusions: In patients who have normal left ventricular regional wall motion analysis S% obtained using dobutamine stress pulsed-wave tissue Doppler echocar- diography may be useful in differentiating ischemic segments from non-ischemic ones. Key Words: Dobutamine Stress Echocardiography, Pulsed-Wave Tissue Doppler,İschemia.
Purpose: This study was done to investigate the availability of doppler ecocardiography in the distinction of is- bone and non-skemic myocardial segments. Tools and Methods: The study was carried out on 18 patients (the average age of 56.4±7.7; 7 women, 11 men) with no left ventricular seg-menter kinesis disorder and clinically coronary angiography index. Patients were taken to the ecocardiography laboratory within 24 hours before catheterization. During rest and pic dobutamin infusion using apical acoustic windows, systolic tissue speeds were obtained from the mitral anulus, basal and middle segments. The percentage of increase (S%) was calculated according to the rest measurement of the systolic speed during the dobutamin pic infusion using the measurement speeds. Coronary artery disease has been identified as having at least 50% or more of stenosis in one major epicardial artery. Myocardial segments are divided into 3 groups. The coronary angiography is normal and the segments belonging to the group 1 are counted. The segments of those with coronary artery disease were classified as Group 2 if the normal coronary artery bleeds, and if the coronary artery is stenosis, it was classified as Group 3. Results: In our study, S% was found at 79.0±39.2 in Group 1, 76.1±25.3 in Group 2, 49.2±23.1 in Group 3 (F=19.175, p<0.001). The difference was due to the fact that Group 3 was lower than the others (p<0.001). With the help of the ROC analysis, S% was below 59% and ischemic segments were predicted with 75% sensitivity and 75% specificity. Result: In patients with non-kinesis disorder of the left ventricular segment, the S% obtained by doppler ecocardiography of the dobutamine tissue may be beneficial in distinguishing the ischemic segments from ischemic beans. Keywords: DOBUTAMINE STRESS ECHOCARDIOGRAPHYABSTRACT Objective: To evaluate the utility of DOBUTAMINE stress pulsed-wave tissue Dopp- ech lerocardiography in differentiating ischemic myocardial segments from non-ischemic ones. Materials and Methods: Eighteen patients (mean age 56.4±7. 7, 11 male) who had normal left ventricular regional wall motion analysis at rest and undergoing coronary angiography for clinical reasons were included. In each subject, mitral mothers, basal, and mid-segment systolic velocities were obtained from the apical echocardiographic windows at rest and during the peak dobutamine infusion. Two systolic velocity measu- rements were used to calculate the percentage increase in systolic velocity (S%) during peak dobutamine infusion relative to rest measurements. Coronary artery disease was defined as ≥50 percent stenosis in at least one major epicardial coronary artery. The myocardial segments were classified into 3 groups. The cardiac segments belonging to patients with normal coronary angiograms were Group 1. The cardiac segments belonging to patients with coronary artery disease were classified as Gro- up 2 if the segment was supplied by a normal coronary artery or Group 3 if it was supplied by a stenosed artery. Results: S% values in Groups 1, 2, and 3 were 79.0±39.2, 76.1±25.3, and 49.2±23, respectively (F=19.175, p<0.001). S% values in Group 3 were lower than those in both Groups 1 and 2 (p<0.001). Based on ROC analysis, S% less than 59% predicts ischemic segments with a sensitivity of 75% and a specificity of 75%. Conclusions: In patients who have normal left ventricular regional wall motion analysis S% obtained using dobutamine stress pulsed-wave tissue Doppler echocar- diography may be useful in differentiating ischemic segments from non-ischemic ones. Keywords: Dobutamine Stress Echocardiography, Pulsed-Wave Tissue Doppler, Ischemia.
Field : Sağlık Bilimleri
Journal Type : Uluslararası
Article Detail 
Similar Articles
Journal Information
Listen Paper
Cite
Print This Page
Share
Mendeley
