Transient Ischemic Dilatation during Stress Echocardiography: An Additional Marker of Significant Myocardial Ischemia

Akihisa Kataoka, Marielle Scherrer-Crosbie, Roxy Senior, Patrick Garceau, Silvia Valbuena, Jelena Čelutkienė, Jeffrey L. Hastings, Asim N. Cheema, Alfonso Lara, Elizabeta Srbinovska-Kostovska, Renee Hessian, Daniele Poggio, Richard Goldweit, Muhamed Saric, Khaled A. Dajani, Jeffrey A. Kohn, Leslee J. Shaw, Harmony R. Reynolds, Michael H. Picard

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Aim: Left ventricular (LV) transient ischemic dilatation (TID) is not clear how it relates to inducible myocardial ischemia during stress echocardiography (SE). Methods and Results: Eighty-eight SEs were examined from the site certification phase of the ISCHEMIA Trial. LV end-diastolic volume (EDV) and end-systolic volume (ESV) were measured at rest and peak stages and the percent change calculated. Moderate or greater ischemia was defined as ≥3 segments with stress-induced severe hypokinesis or akinesis. Optimum cut points in stress-induced percent EDV and ESV change that identified moderate or greater myocardial ischemia were analyzed. Analysis from percentage distribution identified a > 13% LV volume increase in EDV or a > 9% LV volume increase in ESV as the optimum cutoff points for moderate or greater ischemia. Using these definitions for TID, there were 27 (31%) with TIDESV and 12 (14%) with TIDEDV. By logistic regression analysis and receiver operating characteristic curves, the percent change in ESV had a stronger association with moderate or greater myocardial ischemia than that of EDV change. Compared to those without TIDESV, cases with TIDESV had larger extent of inducible wall-motion abnormalities, lower peak stress LVEF, and higher likelihood of moderate or grater ischemia. For moderate or greater myocardial ischemia detection, TIDESV had a sensitivity of 46%, specificity of 83%, positive predictive value of 70%, and negative predictive value of 64%. Conclusion: Transient ischemic dilatation by SE is a marker of extensive myocardial ischemia and can be used as an additional marker of higher risk.

Original languageEnglish (US)
Pages (from-to)1202-1208
Number of pages7
JournalEchocardiography
Volume33
Issue number8
DOIs
StatePublished - Aug 1 2016

Fingerprint

Stress Echocardiography
Myocardial Ischemia
Dilatation
Ischemia
Certification
ROC Curve
Stroke Volume
Logistic Models
Regression Analysis
Sensitivity and Specificity

Keywords

  • coronary artery disease
  • myocardial ischemia
  • stress echocardiography

ASJC Scopus subject areas

  • Medicine(all)
  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Kataoka, A., Scherrer-Crosbie, M., Senior, R., Garceau, P., Valbuena, S., Čelutkienė, J., ... Picard, M. H. (2016). Transient Ischemic Dilatation during Stress Echocardiography: An Additional Marker of Significant Myocardial Ischemia. Echocardiography, 33(8), 1202-1208. https://doi.org/10.1111/echo.13222

Transient Ischemic Dilatation during Stress Echocardiography : An Additional Marker of Significant Myocardial Ischemia. / Kataoka, Akihisa; Scherrer-Crosbie, Marielle; Senior, Roxy; Garceau, Patrick; Valbuena, Silvia; Čelutkienė, Jelena; Hastings, Jeffrey L.; Cheema, Asim N.; Lara, Alfonso; Srbinovska-Kostovska, Elizabeta; Hessian, Renee; Poggio, Daniele; Goldweit, Richard; Saric, Muhamed; Dajani, Khaled A.; Kohn, Jeffrey A.; Shaw, Leslee J.; Reynolds, Harmony R.; Picard, Michael H.

In: Echocardiography, Vol. 33, No. 8, 01.08.2016, p. 1202-1208.

Research output: Contribution to journalArticle

Kataoka, A, Scherrer-Crosbie, M, Senior, R, Garceau, P, Valbuena, S, Čelutkienė, J, Hastings, JL, Cheema, AN, Lara, A, Srbinovska-Kostovska, E, Hessian, R, Poggio, D, Goldweit, R, Saric, M, Dajani, KA, Kohn, JA, Shaw, LJ, Reynolds, HR & Picard, MH 2016, 'Transient Ischemic Dilatation during Stress Echocardiography: An Additional Marker of Significant Myocardial Ischemia', Echocardiography, vol. 33, no. 8, pp. 1202-1208. https://doi.org/10.1111/echo.13222
Kataoka A, Scherrer-Crosbie M, Senior R, Garceau P, Valbuena S, Čelutkienė J et al. Transient Ischemic Dilatation during Stress Echocardiography: An Additional Marker of Significant Myocardial Ischemia. Echocardiography. 2016 Aug 1;33(8):1202-1208. https://doi.org/10.1111/echo.13222
Kataoka, Akihisa ; Scherrer-Crosbie, Marielle ; Senior, Roxy ; Garceau, Patrick ; Valbuena, Silvia ; Čelutkienė, Jelena ; Hastings, Jeffrey L. ; Cheema, Asim N. ; Lara, Alfonso ; Srbinovska-Kostovska, Elizabeta ; Hessian, Renee ; Poggio, Daniele ; Goldweit, Richard ; Saric, Muhamed ; Dajani, Khaled A. ; Kohn, Jeffrey A. ; Shaw, Leslee J. ; Reynolds, Harmony R. ; Picard, Michael H. / Transient Ischemic Dilatation during Stress Echocardiography : An Additional Marker of Significant Myocardial Ischemia. In: Echocardiography. 2016 ; Vol. 33, No. 8. pp. 1202-1208.
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T1 - Transient Ischemic Dilatation during Stress Echocardiography

T2 - An Additional Marker of Significant Myocardial Ischemia

AU - Kataoka, Akihisa

AU - Scherrer-Crosbie, Marielle

AU - Senior, Roxy

AU - Garceau, Patrick

AU - Valbuena, Silvia

AU - Čelutkienė, Jelena

AU - Hastings, Jeffrey L.

AU - Cheema, Asim N.

AU - Lara, Alfonso

AU - Srbinovska-Kostovska, Elizabeta

AU - Hessian, Renee

AU - Poggio, Daniele

AU - Goldweit, Richard

AU - Saric, Muhamed

AU - Dajani, Khaled A.

AU - Kohn, Jeffrey A.

AU - Shaw, Leslee J.

AU - Reynolds, Harmony R.

AU - Picard, Michael H.

PY - 2016/8/1

Y1 - 2016/8/1

N2 - Aim: Left ventricular (LV) transient ischemic dilatation (TID) is not clear how it relates to inducible myocardial ischemia during stress echocardiography (SE). Methods and Results: Eighty-eight SEs were examined from the site certification phase of the ISCHEMIA Trial. LV end-diastolic volume (EDV) and end-systolic volume (ESV) were measured at rest and peak stages and the percent change calculated. Moderate or greater ischemia was defined as ≥3 segments with stress-induced severe hypokinesis or akinesis. Optimum cut points in stress-induced percent EDV and ESV change that identified moderate or greater myocardial ischemia were analyzed. Analysis from percentage distribution identified a > 13% LV volume increase in EDV or a > 9% LV volume increase in ESV as the optimum cutoff points for moderate or greater ischemia. Using these definitions for TID, there were 27 (31%) with TIDESV and 12 (14%) with TIDEDV. By logistic regression analysis and receiver operating characteristic curves, the percent change in ESV had a stronger association with moderate or greater myocardial ischemia than that of EDV change. Compared to those without TIDESV, cases with TIDESV had larger extent of inducible wall-motion abnormalities, lower peak stress LVEF, and higher likelihood of moderate or grater ischemia. For moderate or greater myocardial ischemia detection, TIDESV had a sensitivity of 46%, specificity of 83%, positive predictive value of 70%, and negative predictive value of 64%. Conclusion: Transient ischemic dilatation by SE is a marker of extensive myocardial ischemia and can be used as an additional marker of higher risk.

AB - Aim: Left ventricular (LV) transient ischemic dilatation (TID) is not clear how it relates to inducible myocardial ischemia during stress echocardiography (SE). Methods and Results: Eighty-eight SEs were examined from the site certification phase of the ISCHEMIA Trial. LV end-diastolic volume (EDV) and end-systolic volume (ESV) were measured at rest and peak stages and the percent change calculated. Moderate or greater ischemia was defined as ≥3 segments with stress-induced severe hypokinesis or akinesis. Optimum cut points in stress-induced percent EDV and ESV change that identified moderate or greater myocardial ischemia were analyzed. Analysis from percentage distribution identified a > 13% LV volume increase in EDV or a > 9% LV volume increase in ESV as the optimum cutoff points for moderate or greater ischemia. Using these definitions for TID, there were 27 (31%) with TIDESV and 12 (14%) with TIDEDV. By logistic regression analysis and receiver operating characteristic curves, the percent change in ESV had a stronger association with moderate or greater myocardial ischemia than that of EDV change. Compared to those without TIDESV, cases with TIDESV had larger extent of inducible wall-motion abnormalities, lower peak stress LVEF, and higher likelihood of moderate or grater ischemia. For moderate or greater myocardial ischemia detection, TIDESV had a sensitivity of 46%, specificity of 83%, positive predictive value of 70%, and negative predictive value of 64%. Conclusion: Transient ischemic dilatation by SE is a marker of extensive myocardial ischemia and can be used as an additional marker of higher risk.

KW - coronary artery disease

KW - myocardial ischemia

KW - stress echocardiography

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