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Clinical Trial
. 2010 Mar 24:8:10.
doi: 10.1186/1476-7120-8-10.

Feasibility of real-time three-dimensional stress echocardiography: pharmacological and semi-supine exercise

Lorenza Pratali  1 , Sabrina Molinaro, Anca I Corciu, Emilio M Pasanisi, Marco Scalese, Rosa Sicari
Affiliations
Clinical Trial

Feasibility of real-time three-dimensional stress echocardiography: pharmacological and semi-supine exercise

Lorenza Pratali et al. Cardiovasc Ultrasound. .

Abstract

Background: Real time three dimensional (RT3D) echocardiography is an accurate and reproducible method for assessing left ventricular shape and function.

Aim: assess the feasibility and reproducibility of RT3D stress echocardiography (SE) (exercise and pharmacological) in the evaluation of left ventricular function compared to 2D.

Methods and results: One hundred eleven patients with known or suspected coronary artery disease underwent 2D and RT3DSE. The agreement in WMSI, EDV, ESV measurements was made off-line.The feasibility of RT-3DSE was 67%. The inter-observer variability for WMSI by RT3D echo was higher during exercise and with suboptimal quality images (good: k = 0.88; bad: k = 0.69); and with high heart rate both for pharmacological (HR < 100 bpm, k = 0.83; HR > or = 100 bpm, k = 0.49) and exercise SE (HR < 120 bpm, k = 0.88; HR > or = 120 bpm, k = 0.78). The RT3D reproducibility was high for ESV volumes (0.3 +/- 14 ml; CI 95%: -27 to 27 ml; p = n.s.).

Conclusions: RT3DSE is more vulnerable than 2D due to tachycardia, signal quality, patient decubitus and suboptimal resting image quality, making exercise RT3DSE less attractive than pharmacological stress.

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Figures

Figure 1
Figure 1
RT3D feasibility at rest: 27 patients were excluded from analysis because of translational artefact or for un-interpretable images. Ten patients were excluded for un-interpretable images at peak stress. Of 37 RT3D echo tests excluded from analysis, 25 were exercise and 12 pharmacological tests.
Figure 2
Figure 2
Distribution of patients according to RT3D image quality separating the study group into pharmacological and exercise stress echo.
Figure 3
Figure 3
Agreement between two different observers for the evaluation of RT3D WMSI considering two different groups: exercise and pharmacological stress echo. In the graph the K value according to image quality and heart rate at peak stress is reported.
Figure 4
Figure 4
Coefficient of variation for LV ED and ES volumes in pharmacological and exercise stress at different heart rate values at peak stress.
See this image and copyright information in PMC

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