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

doi:10.1111/echo.13222

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 journal › Article › peer-review

10 Scopus citations

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 TID_ESV and 12 (14%) with TID_EDV. 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 TID_ESV, cases with TID_ESV 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, TID_ESV 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 language	English
Pages (from-to)	1202-1208
Number of pages	7
Journal	Echocardiography
Volume	33
Issue number	8
DOIs	https://doi.org/10.1111/echo.13222
State	Published - 1 Aug 2016
Externally published	Yes

Keywords

coronary artery disease
myocardial ischemia
stress echocardiography

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10.1111/echo.13222

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Kataoka, A., Scherrer-Crosbie, M., Senior, R., Garceau, P., Valbuena, S., Čelutkienė, J., Hastings, J. L., Cheema, A. N., Lara, A., Srbinovska-Kostovska, E., Hessian, R., Poggio, D., Goldweit, R., Saric, M., Dajani, K. A., Kohn, J. A., Shaw, L. J., Reynolds, H. R., & 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

@article{5d595d1abb8f4b8fa1bfcd1de158b1b4,

title = "Transient Ischemic Dilatation during Stress Echocardiography: An Additional Marker of Significant Myocardial Ischemia",

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.",

keywords = "coronary artery disease, myocardial ischemia, stress echocardiography",

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

note = "Publisher Copyright: {\textcopyright} 2016, Wiley Periodicals, Inc.",

year = "2016",

month = aug,

day = "1",

doi = "10.1111/echo.13222",

language = "English",

volume = "33",

pages = "1202--1208",

journal = "Echocardiography",

issn = "0742-2822",

publisher = "John Wiley and Sons Inc.",

number = "8",

}

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

TY - JOUR

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

UR - http://www.scopus.com/inward/record.url?scp=84983434369&partnerID=8YFLogxK

U2 - 10.1111/echo.13222

DO - 10.1111/echo.13222

M3 - Article

C2 - 27040889

AN - SCOPUS:84983434369

SN - 0742-2822

VL - 33

SP - 1202

EP - 1208

JO - Echocardiography

JF - Echocardiography

IS - 8

ER -

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

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Keywords

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