Speckle tracking during dobutamine stress echocardiogram in treadmill test positive patients with normal coronary angiogram
M Narayan Bhat, Dalal Akshay Madhukar, Sushmitha Upadhyaya
Strain Rate Imaging During Dobutamine Stress Echo is A Novel Concept to Study Coronary Artery Disease. Objective:The Aim of the study was to compare the results of the Regional Wall Motion Abnormality assessed in DSE+STE with the ST-T changes in TMT. The study also uses the 17-segment model of the myocardium and compares DSE with DSE+STE to see if the later provides better accuracy over the former in assessing regional wall motion abnormality (RWMA) in the segments. Methods: The current study has been undertaken in 25 patients with a positive Treadmill Test (TMT) test and a normal coronary angiogram (CAG) to look for any signs of myocardial ischemia detected on 3D-STE with and without Dobutamine Stress Testing. Results: The mean trend observed was a decrease in GLS from pre-DSE (18.916) to post-DSE (14.152). In the study we found that GLS was affected by age, younger patients in the study had higher GLS as compared to the older patients20 of the 25 patients studied had reduced GLS as well as segmental strain. In 5 patients the GLS increased at peak HR than the base lineThe study demonstrates the presence of significant Myocardial Ischemia in number of patients with a positive TMT and a normal coronary angiogram with evidence of myocardial ischemia on DSE when analysed with speckle tracking. Conclusions: The patients with a decrease in strain and SR on DSE with speckle tracking, potentially have ischemic myocardium despite a normal CAG.