Left ventricular myocardial and cavity velocity disturbances are stronger predictors of stress induced ischaemia in patients with significant coronary artery disease

Abstract Background and aim Dobutamine stress echocardiography (DSE) is a well-established non-invasive investigation for significant coronary artery disease (CAD). The of this study was to evaluate the accuracy cardiac Doppler parameters in predecting CAD. Methods We prospectively studied 103 consecutive patients with suspected CAD based on typical symptoms, 59 proved have 44 no-CAD (n=44). All underwent complete echocardiographic examination, including tissue Doppler, long axis velocities total isovolumic time (T-IVT) as marker cavity dyssynchrony, determined [60 − (total ejection (ET) + filling (FT))]. wall motion score index (WMSI) also calculated. Results were older, had less females, prevalent risk factors higher CT calcium compared (p<0.05, all). At peak dobutamine compromised LV longitudinal excursion (MAPSE), systolic septal lateral (s'), TAPSE diastolic indices more pronounced those without CAD, but dimension did not differ between groups (p>0.05). WMSI t-IVT prolonged (p<0.01, both). Similarly, changes insignificant On multivariate model, delta mean s' OR 2.016 (1.610–3.490, p<0.001), E velocity 1.822 (1.179–2.360, 1.406 (1.180–2.180, FT 1.911 (1.401–2.710, p=0.001), most powerful independent predictors presence particularly when (>50%). Delta <5.0 85% sensitive, 89% specific AUC 0.92. Respective values <6.0 cm/s 82%, 90% 0.91; >4.5, 78%, 77% 0.81 ≥150ms, 76%, 78% 0.84 predicating WMSI≥0.7 75% predicting DSE (80% vs 74%; p=0.03). Conclusions Compromised function, lower wave, increased significance These finding strengthen role comprehensive analysis diagnosing ischaemic disturbances secondary Funding Acknowledgement Type funding sources: None.