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Titolo:
Long axis electromechanics during dobutamine stress in patients with coronary artery disease and left ventricular dysfunction
Autore:
Duncan, AM; OSullivan, CA; Carr-White, GS; Gibson, DG; Henein, MY;
Indirizzi:
Royal Brompton Hosp, Dept Echocardiog, London SW3 6NP, England Royal Brompton Hosp London England SW3 6NP diog, London SW3 6NP, England
Titolo Testata:
HEART
fascicolo: 4, volume: 86, anno: 2001,
pagine: 397 - 404
SICI:
1355-6037(200110)86:4<397:LAEDDS>2.0.ZU;2-J
Fonte:
ISI
Lingua:
ENG
Soggetto:
DOPPLER-ECHOCARDIOGRAPHY; DIASTOLIC FUNCTION; MITRAL ANNULUS; RELAXATION; PATTERN; FLOW;
Keywords:
stress echo cardiography; activation; inotropy; incoordination;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
22
Recensione:
Indirizzi per estratti:
Indirizzo: Henein, MY Royal Brompton Hosp, Dept Echocardiog, Sydney St, London SW3 6NP, England Royal Brompton Hosp Sydney St London England SW3 6NP , England
Citazione:
A.M. Duncan et al., "Long axis electromechanics during dobutamine stress in patients with coronary artery disease and left ventricular dysfunction", HEART, 86(4), 2001, pp. 397-404

Abstract

Objective-To dissociate the effect of inotropy from activation change during dobutamine stress on left ventricular long axis function in patients with coronary artery disease (CAD). Methods-25 patients with CAD and normal left ventricular cavity size and 30 with cavity dilatation-18 with normal activation (DCM-NA) and 12 with left bundle branch block (DCM-LBBB)-were compared with 20 controls. 12 lead ECG and septal long axis echograms were assessed at rest and peak dobutamine stress. Amplitude, shortening and lengthening velocities, postejection shortening, Q wave to onset of shortening (Q-OS), and A2 to onset of lengthening (A2-OL) were measured. Inotropy was evaluated from peak aortic acceleration. Results-In controls, amplitude, shortening and lengthening velocities, andpeak aortic acceleration increased with stress; QRS, Q-OS, and A2-OL shortened (all p < 0.001); and contraction remained coordinate. In the group of patients with CAD and normal left ventricular cavity size, shortening velocity and peak aortic acceleration increased with stress (p < 0.005). However, amplitude and lengthening velocity did not change, QRS, Q-OS, and A2-OL lengthened (p < 0.01), and incoordination appeared. Results were similar in the group with DCM-NA. In the DCM-LBBB group, shortening velocity and peak aortic acceleration increased modestly with stress (p < 0.01) but amplitude, lengthening velocity, QRS, Q-OS, A2-OL, and incoordination remained unchanged. Overall, change in shortening velocity correlated with that in peak aortic acceleration (r(2) = 0.71), in amplitude with that in lengthening velocity (r(2) = 0.74), and in QRS with both Q-OS (r(2) = 0.69) and A2-OL (r(2) = 0.63). Conclusion-The normal long axis response to dobutamine reflects both inotropy and rapid activation. In CAD, inotropy is preserved with development ofischaemia but the normal increase in amplitude is lost and prolonged activation delays the time course of shortening, causing pronounced incoordination. Overall, shortening rate uniformly reflects inotropy while lengthening rate depends mainly on systolic amplitude rather than primary diastolic involvement, even with overt ischaemia.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 09/07/20 alle ore 15:43:21