Non-invasive diagnosis of coronary artery disease by quantitative stress echocardiography: optimal diagnostic models using off-line tissue Doppler in the MYDISE study

摘要: Aims To develop optimal methods for the objective non-invasive diagnosis of coronary artery disease, using myocardial Doppler velocities during dobutamine stress echocardiography. Methods and results We acquired tissue digital data in 289 subjects, measured responses by off-line analysis 11 left ventricular segments. Diagnostic criteria developed comparing 92 normal subjects with 48 patients disease were refined a prospective series 149 referred chest pain. Optimal diagnostic accuracy was achieved logistic regression models, systolic at maximal 7 segments, adjusting independent correlations directly heart rate inversely age female gender (all p <0.001). Best cut-points from receiver-operator curves diagnosed anterior descending, circumflex right sensitivities specificities 80% 80%, 91% 93% 82%, respectively. All models performed better than velocity cut-offs alone ( <0.001). Conclusion Non-invasive quantitative echocardiography is best based on segmental peak rate, or age.