| Title: |
P1555 Delta mapse: an easy-to-use tool to evaluate coronary artery stenosis during dypiridamole pharmacological stress echocardiography |
| Authors: |
Moderato, L; Binno, S M; Pastorini, G; Dallospedale, C; Benatti, G; Lazzeroni, D; Piepoli, M; Aschieri, D; Villani, G Q |
| Source: |
European Heart Journal - Cardiovascular Imaging ; volume 21, issue Supplement_1 ; ISSN 2047-2404 2047-2412 |
| Publisher Information: |
Oxford University Press (OUP) |
| Publication Year: |
2020 |
| Description: |
Background Dypiridamol stress echocardiography (DSE) is an important tool for detecting reversible ischemia in patients with suspected coronary artery disease (CAD); nonetheless the results of the test are related to visualization of wall motion abnormalities, moderately operator-dependent, and left anterior descending (LAD) artery reserve, resulting in a moderate sensibility and specificity. Aim of our study was to evaluate whether an an easy-to-use parameter like mitral annular plane systolic excursion (MAPSE) could be useful to identify CAD during DSE. Methods We prospectively enrolled 300 patients with suspected CAD and perform a DSE; at rest and peak MAPSE was acquired. 59 patients with reversibile ischemia during stress echocardiography (positive) were referred to perform coronary angiography. Patients were divided according to MAPSE behaviour during DSE: group 1 (MAPSE ≤ 0) and group 2 (delta MAPSE > 0 mm). Results The mean age of was 63 ± 11 years, male gender was prevalent (73%); no differences were found in risk factors and left vetnricular ejection fraction (LV-EF) between two groups.Coronary arteries were normal in 14 patients (23%), while significant stenosis (>70%) was found in 45 patients (77%); in 31 patients (53%) left main (LM) or proximal LAD artery were involved, while in 17 (29%) and 22 (37%) right coronary artery and circumflex artery were affected respectively. Patients with CAD showed a lower (blunted or no increase) MAPSE after dypiridamole infusion, with a significative difference in Delta Mapse (Mapse peak-Mapse rest) between groups (0,2 mm vs 2,8 mm p = 0,004) (Figure 1B). By using a Receiver Operating Curve, the Area under the curve was 0,757, with the best cut-off value for CAD prediction at Delta Mapse= +2.5 mm (sensibility 0,667 and specificity 0,809 – p = 0.012 - Figure 1b). In particular, Delta Mapse was able to predict LM/LAD stenosis (Figure 1B AUC = 0.679 ;p = 0.019), rather than right coronary artery and circumflex artery disease, with higher ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1093/ehjci/jez319.976 |
| Availability: |
https://doi.org/10.1093/ehjci/jez319.976; http://academic.oup.com/ehjcimaging/article-pdf/21/Supplement_1/jez319.976/31866261/jez319.976.pdf |
| Rights: |
https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model |
| Accession Number: |
edsbas.891674EC |
| Database: |
BASE |