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Real-time three-dimensional dobutamine stress echocardiography in assessment of ischemia: comparison with two-dimensional dobutamine stress echocardiography

^a Division of Cardiology, University of Texas Medical Branch-Galveston, Galveston, Texas, USA

View larger version (75K): [in a new window]   Figure 1 Parasternal real-time three-dimensional echocardiography (RT-3D) acquisition. (A) The elevational plane was steered right-to-left across the reference long-axis view (LAX) to obtain corresponding short-axis views (SAX). (B) Reference long-axis image with corresponding short-axis images obtained at the basal, mid- and apical levels by steering the elevational plane (white line).

View larger version (49K): [in a new window]   Figure 2 Apical real-time three-dimensional echocardiography (RT-3D) acquisition. (A) A scheme of apical four-chamber (A4) reference view with elevational plane tilted to obtain adjusted apical two-chamber view. (B) Apical four-chamber (A4) and the adjusted apical two-chamber (A2) images. (C) A scheme of apical four-chamber (A4) reference view with short-axis slices parallel to the transducer to display parallel C-scans (C1 and C2). (D) Apical four-chamber (A4) and C-scan (C1 and C2) images.

View larger version (27K): [in a new window]   Figure 3 Left ventricular segments and corresponding coronary artery supply in real-time three-dimensional parasternal and apical views. Ant = anterior; Inf = inferior; LAD = left anterior descending artery; Lat = lateral; LCX = left circumflex artery; RCA = right coronary artery; Sept = septal.

View larger version (97K): [in a new window]   Figure 4 Apical real-time three-dimensional systolic frames at baseline and at peak stress in a patient with inducible ischemia. Arrows point to the inducible left ventricular wall motion abnormality at peak stress in A2, C1 and C2 images.

View larger version (15K): [in a new window]   Figure 5 Concordance of left ventricular wall motion interpretation by real-time three-dimensional echocardiography (RT-3D) and two-dimensional echocardiography (2D). Abnormal left ventricular wall motion at baseline (A) and ischemia at peak stress (B).