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Cv(}חL;nW U@MP׃IG¿ K8k ؑG X8VV-/6!&HmLu3&1W[=2b>;y`2M̾lk♡ Ce;w'mK'/NjK"٣G̿BB0?;BXWG*] >MQ2D=bt(/Sޱsa1nwg@6߁~˲m ^ sT3FVq} LJU=\Luh.)0B:i nGRVD/82F23Pdk>1vİHټ)hGNR;#q;&`|dp%isQ=T z+^^fe 8z@Va);Zmݧ{bo$VDёR O색Bܤh#a L ;/d#_8AJ,̠{΁(`o"@OŎyрk1ˌh?j.ƛ8;o NK$6blzwU06b F!^c $`g7Sa>!G5=͇{3R[ɢ^"וWU57'C12@'{kFbjAv4#GJhGu>3AQU)`o0;?,/) u63}"ֳNՍꇤqܻ*feg siXbwW:yٟ/"hg?ZQ1{<"!I84x@ B|l$Mұ KIk&x~h26\*#{@&e;qS_Y#0ΆgfFǝ?}V~ctA*(}殘Ӻݶ/Ϝ0 ;xEh,-u1qtff3lyn:wtK[k x2ԛ٪mHJH,KnG]̱Ʈ^@[A; 7ފ sTV̆R wxE8Tf6!>TnZwZR*jQkp4H/߂it+d ƛΚTk}]v`:9靚^ڇ!ұ^++[跄sٺ־@$XNzk0oz{۞3=3^]P+rx|ݿK3qңxCͣiqpY0\ٗo4(.]6! #0Yȯ 8XrIz*ƎaR=HƢ8O~oĂ_ ހO7H9O:rxwM[_Y<50$@B[ϻ/":eAh'C9ڿzloPH ` G.GSN)"% vsoػ`AƬr]j/chm^zW難j!M͎kIEh ^x]LK{pQEUރőUZ5P5ⶽ`8I?Ms\BQ d3 endstream endobj 41 0 obj <> endobj 118 0 obj <>stream x}WyXǶq&rIf&bDq,QAvapTafp ; ( F\0DKy1{znw_ T9wN)e2Aەq!JŌ%-q)9o/([ 2ċ<Њx7E:11)S>s\wgs=Y6/SWoȌO͐HU(8-[c[dȕJqK5. 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Cv(}חL;nW U@MP׃IG¿ K8k ؑG X8VV-/6!&HmLu3&1W[=2b>;y`2M̾lk♡ Ce;w'mK'/NjK"٣G̿BB0?;BXWG*] >MQ2D=bt(/Sޱsa1nwg@6߁~˲m ^ sT3FVq} LJU=\Luh.)0B:i nGRVD/82F23Pdk>1vİHټ)hGNR;#q;&`|dp%isQ=T z+^^fe 8z@Va);Zmݧ{bo$VDёR O색Bܤh#a L ;/d#_8AJ,̠{΁(`o"@OŎyрk1ˌh?j.ƛ8;o NK$6blzwU06b F!^c $`g7Sa>!G5=͇{3R[ɢ^"וWU57'C12@'{kFbjAv4#GJhGu>3AQU)`o0;?,/) u63}"ֳNՍꇤqܻ*feg siXbwW:yٟ/"hg?ZQ1{<"!I84x@ B|l$Mұ KIk&x~h26\*#{@&e;qS_Y#0ΆgfFǝ?}V~ctA*(}殘Ӻݶ/Ϝ0 ;xEh,-u1qtff3lyn:wtK[k x2ԛ٪mHJH,KnG]̱Ʈ^@[A; 7ފ sTV̆R wxE8Tf6!>TnZwZR*jQkp4H/߂it+d ƛΚTk}]v`:9靚^ڇ!ұ^++[跄sٺ־@$XNzk0oz{۞3=3^]P+rx|ݿK3qңxCͣiqpY0\ٗo4(.]6! #0Yȯ 8XrIz*ƎaR=HƢ8O~oĂ_ ހO7H9O:rxwM[_Y<50$@B[ϻ/":eAh'C9ڿzloPH ` G.GSN)"% vsoػ`AƬr]j/chm^zW難j!M͎kIEh ^x]LK{pQEUރőUZ5P5ⶽ`8I?Ms\BQ d3 endstream endobj 68 0 obj <> endobj 119 0 obj <>stream x}WyXǶq&rIf&bDq,QAvapTafp ; ( F\0DKy1{znw_ T9wN)e2Aەq!JŌ%-q)9o/([ 2ċ<Њx7E:11)S>s\wgs=Y6/SWoȌO͐HU(8-[c[dȕJqK5. 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Cv(}חL;nW U@MP׃IG¿ K8k ؑG X8VV-/6!&HmLu3&1W[=2b>;y`2M̾lk♡ Ce;w'mK'/NjK"٣G̿BB0?;BXWG*] >MQ2D=bt(/Sޱsa1nwg@6߁~˲m ^ sT3FVq} LJU=\Luh.)0B:i nGRVD/82F23Pdk>1vİHټ)hGNR;#q;&`|dp%isQ=T z+^^fe 8z@Va);Zmݧ{bo$VDёR O색Bܤh#a L ;/d#_8AJ,̠{΁(`o"@OŎyрk1ˌh?j.ƛ8;o NK$6blzwU06b F!^c $`g7Sa>!G5=͇{3R[ɢ^"וWU57'C12@'{kFbjAv4#GJhGu>3AQU)`o0;?,/) u63}"ֳNՍꇤqܻ*feg siXbwW:yٟ/"hg?ZQ1{<"!I84x@ B|l$Mұ KIk&x~h26\*#{@&e;qS_Y#0ΆgfFǝ?}V~ctA*(}殘Ӻݶ/Ϝ0 ;xEh,-u1qtff3lyn:wtK[k x2ԛ٪mHJH,KnG]̱Ʈ^@[A; 7ފ sTV̆R wxE8Tf6!>TnZwZR*jQkp4H/߂it+d ƛΚTk}]v`:9靚^ڇ!ұ^++[跄sٺ־@$XNzk0oz{۞3=3^]P+rx|ݿK3qңxCͣiqpY0\ٗo4(.]6! #0Yȯ 8XrIz*ƎaR=HƢ8O~oĂ_ ހO7H9O:rxwM[_Y<50$@B[ϻ/":eAh'C9ڿzloPH ` G.GSN)"% vsoػ`AƬr]j/chm^zW難j!M͎kIEh ^x]LK{pQEUރőUZ5P5ⶽ`8I?Ms\BQ d3 endstream endobj 95 0 obj <> endobj 120 0 obj <>stream x}WyXǶq&rIf&bDq,QAvapTafp ; ( F\0DKy1{znw_ T9wN)e2Aەq!JŌ%-q)9o/([ 2ċ<Њx7E:11)S>s\wgs=Y6/SWoȌO͐HU(8-[c[dȕJqK5. 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Feasibility of triple imaging vasodilator stress echo in patients with suspected coronary artery disease;
Factibilidad del eco estrés vasodilatador de triple imagen en pacientes con sospecha de enfermedad coronaria

Creators:Ciampi, Quirino, Paterni, Marco, Villari, Bruno, Picano, Eugenio
2016-09-22

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Descripción

Background: Regional wall motion abnormalities (RWMA) are the diagnostic cornerstone of stress echo, but the positivity rate hasbeen declining over the last decades. Additional information is obtained with simultaneous assessment of coronary flow velocityreserve (CFVR) on left anterior descending coronary artery and global left ventricular contractile reserve (LVCR) from the systolicpressure/end-systolic volume relationship.Objective: The aim of this study was to assess the feasibility of triple imaging (RWMA + LVCR + CFVR) during dipyridamole stressecho.Methods: We enrolled 40 consecutive patients (30 men; 62±11 years, mean ejection fraction: 62±7%) referred to testing for suspectedcoronary artery disease. All patients underwent dipyridamole (0.84 mg/kg in 6 min) stress echo. LVCR was defined as theratio between peak and rest elastance index (cuff systolic blood pressure/left ventricular end-systolic volume from biplane Simpsonmethod, normal values: &gt; 1.0). CFVR was defined as the ratio between maximal vasodilation and rest peak diastolic flow velocity inthe left anterior descending coronary artery (normal values &gt;2.0).Results: In 40 consecutive patients, interpretable images were obtained in 40/40 patients (100%) for RWMA, 40/40 (100%) for LVCRand 40/40 (100%) for CFVR. The positivity rate was 1/40 (2%) for RWMA, 4/40 (10%) for LVCR, 6/40 (15%) for CFVR and 9/40(22.5%) with any of the three criteria combined. The average additional imaging time at peak stress after completion of RWMA imagingwas 45 seconds for CFVR; no extra-time was required for LVCR. The average off-line analysis time was 30 seconds for RWMA,55 seconds for LVCR, and 15 seconds for CFVR.Conclusions: Triple imaging vasodilator stress echo was highly feasible and non-time consuming. Abnormal values are more frequentlyfound with CFVR and LVCR than with RWMA. Triple imaging might become the new diagnostic standard in stress echo,and a larger scale validation is now ongoing in the Italian Stress echo 2020 multicenter study.

Introducción: La detección de anormalidades de la motilidad parietal regional (AMPR) es la base del diagnóstico por eco-estrés (EE), pero la tasa de positividad ha ido disminuyendo en las últimas décadas. Por otra parte, se obtiene información adicional de la evaluación simultánea de la reserva de velocidad de flujo coronario (RVFC) de la arteria coronaria descendente anterior y de la reserva contráctil del ventrículo izquierdo (RCVI) a través de la relación presión-volumen de fin de sístole. Objetivo: Evaluar la posibilidad de obtener triple imagen (AMPR + RVFC + RCVI) durante EE con dipiridamol. Métodos: Se enrolaron 40 pacientes consecutivos (30 hombres, con edad media de 62±11 años y fracción de eyección media de 62%±7%) derivados a estudio por sospecha de enfermedad coronaria. Todos los pacientes fueron sometidos a EE con dipiridamol (0.84 mg/kg en 6 min). La RCVI se definió como la relación entre el índice de elastancia máxima y de reposo (presión arterial sistólica medida por esfigmomanometría/volumen de fin de sístole del ventrículo izquierdo por el método de Simpson biplano, con valores normales &gt;1.0). A su vez, la RVFC se definió como la relación entre la vasodilatación máxima y la velocidad máxima del flujo diastólico de reposo en la arteria coronaria descendente anterior (valores normales &gt;2.0). Resultados: Se obtuvieron imágenes viables en 40/40 pacientes (100%) para las AMPR, 40/40 (100%) para la RCVI y 40/40 (100%) para la RVFC. La tasa de positividad fue de 0/40 (0%) para las AMPR, 4/40 (10%) para la RCVI, 6/40 (15%) para la RVFC y 9/40 (22.5%) combinando cualquiera de los tres criterios. El promedio de tiempo adicional de adquisición de imágenes en el estrés pico luego de completar la adquisición de AMPR fue de 45 segundos para la RVFC, y no se requirió tiempo extra para la RCVI. El tiempo promedio de análisis offline fue de 30 segundos para las AMPR, 55 segundos para la RCVI y 15 segundos para la RVFC. Conclusiones: El EE vasodilatador de triple imagen es altamente factible y no consume tiempo adicional. La RVFC y la RCVI proporcionan valores anormales más frecuentemente que las AMPR. La triple imagen podría convertirse en el nuevo referente diagnóstico del EE. Una validación a gran escala se está llevando a cabo actualmente en el estudio multicéntrico italiano Stress echo 2020.

Metadatos destacados

Colecciones
Argentine Journal of Cardiology

Editor

Sociedad Argentina de Cardiología

Fuente

Revista Argentina de Cardiología; Vol 84, No 4 (2016); 322-328, Argentine Journal of Cardiology; Vol 84, No 4 (2016); 322-328

Citación

Ciampi, Quirino et al., “Feasibility of triple imaging vasodilator stress echo in patients with suspected coronary artery disease,” Archivo PPCT, consulta 2 de abril de 2026, http://archivoppct.caicyt.gov.ar/items/show/8869.

Dublin Core

Autor

Ciampi, Quirino
Paterni, Marco
Villari, Bruno
Picano, Eugenio

Fuente

Revista Argentina de Cardiología; Vol 84, No 4 (2016); 322-328
Argentine Journal of Cardiology; Vol 84, No 4 (2016); 322-328

Editor

Sociedad Argentina de Cardiología

Fecha

2016-09-22

Derechos

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Those signing below certify that we have full responsibility for the conduction of this study and for the design and interpretation of the information. We wrote the manuscript and are responsible for its decision. Each of us fulfills the definition of authorship as stated by the International Committee of Medical Journal Editors ( www.icmje.org). We have signed and approved the final manuscript. Neither the manuscript, nor any essential part thereof, including tables and figures, will be published or accepted for refereeing elsewhere before being published in the Journal. We have also read the "Conflict of Interest" section and would disclose any existing. We state that if our manuscript is published in the RAC, we shall transfer the copyright to the Journal.

Formato

Idioma

spa
eng

Tipo

info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion