Experimental Validation of Circumferential, Longitudinal, and Radial 2-Dimensional Strain During Dobutamine Stress Echocardiography in Ischemic Conditions
Patricia Reant, MD*, ,1,
Louis Labrousse, MD*,,
Stephane Lafitte, MD, PhD*,,*,
Pierre Bordachar, MD*,,
Xavier Pillois, PhD*,
Liliane Tariosse, MS*,
Simone Bonoron-Adele, MS*,
Philippe Padois, MS*,
Claude Deville, MD,
Raymond Roudaut, MD and
Pierre Dos Santos, MD, PhD*,
* INSERM U828 and IFR4, University of Bordeaux 2, Bordeaux, France
Bordeaux University Hospital, Bordeaux, France.
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Figure 1 Example
Quantification of peaks (white arrows) in circumferential strain in end systole in risk areas (yellow curve) and control areas (blue curve) in the (A) absence of coronary stenosis and (B) presence of flow-limiting stenosis 25%.
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Figure 2 Experimental Protocol
Hemodynamic data, echocardiographic measurements, and sonomicrometry were recorded during control and ischemic conditions, at rest, and during dobutamine infusion. Stabilization periods of 15 min was defined for dobutamine stress measurements and 30 min after the end of the dobutamine infusion to return to resting condition. Dob = dobutamine; FLS 25% = flow-liming stenosis with 25% reduction in LAD resting flow; H = hemodynamic measurements; LAD = left anterior descending coronary artery mean; NFLS 40% = nonflow-limiting stenosis with 40% reduction in LAD hyperemic flow.
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Figure 3 Comparison of Longitudinal 2D Strain With Sonomicrometry Under Control and Ischemic Conditions at Rest and After an Intravenous Infusion of 30 µg/kg/min Dobutamine
(A) Linear regression analysis of pooled data (at rest + after intravenous infusion of 30 µg/kg/min dobutamine). (B) Bland-Altman analysis of pooled data (at rest + after infusion of dobutamine). (C) Linear regression analysis at rest. (D) Bland-Altman analysis at rest. (E) Linear regression analysis after dobutamine infusion. (F) Bland-Altman analysis after dobutamine infusion.
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Figure 4 Comparison of Radial 2D Strain With Sonomicrometry Under Control and Ischemic Conditions at Rest and After an Intravenous Infusion of 30 µg/kg/min Dobutamine
(A) Linear regression analysis of pooled data (at rest + after intravenous infusion of 30 µg/kg/min dobutamine). (B) Bland-Altman analysis of pooled data (at rest + after infusion of dobutamine). (C) Linear regression analysis at rest. (D) Bland-Altman analysis at rest. (E) Linear regression analysis after dobutamine infusion. (F) Bland-Altman analysis after dobutamine infusion.
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Figure 5 Comparison of Circumferential 2D Strain With Sonomicrometry Under Control and Ischemic Conditions at Rest and After an Intravenous Infusion of 30 µg/kg/min Dobutamine
(A) Linear regression analysis of pooled data (at rest + after intravenous infusion of 30 µg/kg/min dobutamine). (B) Bland-Altman analysis of pooled data (at rest + after infusion of dobutamine). (C) Linear regression analysis at rest. (D) Bland-Altman analysis at rest. (E) Linear regression analysis after dobutamine infusion. (F) Bland-Altman analysis after dobutamine infusion.
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Figure 6 Myocardial Strains Measured by 2D Strain in RA and CA at Rest and During Dobutamine Stress
*p < 0.05 versus no stenosis (base); p < 0.05 versus rest. CS = circumferential strain (in %); LS = longitudinal strain (in %); RS = radial strain (in %); WT = wall thickening (in %); other abbreviations as in Figure 2.
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