Visual Assessment and Longitudinal Strain During Dobutamine Stress Echocardiography

Abstract

Background/Objectives: Dobutamine stress echocardiography (DSE) is a non-invasive diagnostic technique commonly employed in routine clinical practice to identify coronary artery disease. Emerging echocardiographic methods, including strain and strain rate imaging, quantify alterations in myocardial contractility and may improve the diagnostic accuracy of DSE. The main aim of this study was to assess the correlation between visual interpretation and longitudinal strain during dobutamine stress echocardiography. Methods: Our study was observational and was conducted at the Cardiology Clinic of the University Clinical Center of the Republic of Srpska. It included 70 patients who underwent dobutamine stress echocardiography. The patients were divided into two groups (diagnostic and viable study). A visual assessment of segmental contractility of the left ventricle was performed, as well as an assessment of contractility with longitudinal strain (LS) during the test. Results: The median baseline LS of segments without impaired contractility in the diagnostic study was -20% (-21 to -18) and, at the peak of the test, -22% (-23 to -21), which was statistically significant (p < 0.05). The median baseline LS in the segments with impaired contractility was -17% (-18 to -16) and, at the peak of the test, -13% (-15 to -12), which was statistically significant (p < 0.05). In the viability study, the average baseline LS in the segments with improved contractility was -8% (-11 to -7) and, at the peak of the test, -14% (-17 to -13), which was statistically significant (p < 0.05). The average baseline LS in the segments without improved contractility was -6% (-5 to -7) and, at the peak of the test, -2% (-3 to -0), which was statistically significant (p < 0.05). Conclusions: Our study indicates a good correlation between a visual assessment of left ventricular segment contractility and longitudinal strain during dobutamine stress echocardiography.

Keywords: diagnostic study; dobutamine stress echocardiography; longitudinal strain; viability study; visual assessment.

Figure 1

Longitudinal strain and visually assessed contractility.