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Influence of wall stress and left ventricular geometry on the accuracy of dobutamine stress echocardiography

^* University of Queensland, Brisbane, Australia

View larger version (37K): [in a new window]   Figure 1 The left ventricular (LV) geometric pattern, classified according to relative wall thickness and LV mass index. CH = concentric hypertrophy; CR = concentric remodeling; EH = eccentric hypertrophy; LVMI = left ventricular mass index; N = normal geometry; RWT = relative wall thickness.

View larger version (45K): [in a new window]   Figure 2 Sensitivity (left), specificity (center), and accuracy (right) of dobutamine stress echocardiography, according to the left ventricular geometric pattern. White bars = normal geometry (N); light gray bars = concentric remodeling (CR); dark gray bars = concentric hypertrophy (CH); black bars = eccentric hypertrophy (EH).

View larger version (32K): [in a new window]   Figure 3 Sensitivity (left), specificity (center), and accuracy (right) of dobutamine stress echocardiography, according to quartiles of circumferential end-systolic wall stress (cESS) at peak (1st = lowest quartile [<90 kdyne/cm2], 2nd = 2nd lowest quartile [90 to 115 kdyne/cm2], 3rd = 3rd lowest quartile [116 to 144 kdyne/cm2], 4th = highest quartile [145 kdyne/cm2]).

View larger version (32K): [in a new window]   Figure 4 Sensitivity (left), specificity (center), and accuracy (right) of dobutamine stress echocardiography, according to quartiles of meridional end-systolic wall stress (mESS) at peak (1st = lowest quartile [<30 kdyne/cm2], 2nd = 2nd lowest quartile [30 to 38 kdyne/cm2], 3rd = 3rd lowest quartile [39 to 49 kdyne/cm2], 4th = highest quartile [50 kdyne/cm2]).

View larger version (28K): [in a new window]   Figure 5 Correlation of left ventricular fractional shortening at peak with circumferential end-systolic wall stress at peak (cESS) (left) and meridional end-systolic wall stress (mESS) at peak (right).