Diagnostic usefulness of quantitative tissue velocity imaging and anatomic M-mode echocardiography for coronary artery diseases: A pilot study.

Abstract

To explore the potential clinical usefulness and determine optimal diagnostic criteria of quantitative tissue velocity imaging and anatomic M-mode echocardiography in patients with coronary artery disease (CAD). We used quantitative tissue velocity imaging for the measurement of systolic myocardial velocity, and anatomic M-mode echocardiography for the measurement of ventricular wall-thickening fraction in 44 subjects with suspected CAD. Subjects were classified as patients if coronary angiography demonstrated a stenosis ≥ 50%, and as controls if it was strictly normal. The diagnostic criteria, sensitivity, and specificity were assessed by receiver-operator curves. Controls had greater mean systolic myocardial velocity and ventricular wall-thickening fraction in the basal (6.59 ± 1.25 cm/s and 0.44 ± 0.05) and mid segment (5.23 ± 0.93 cm/s and 0.43 ± 0.04) than patients (5.02 ± 1.17 cm/s and 0.29 ± 0.04, 3.27 ± 1.29 cm/s and 0.29 ± 0.04, respectively, p < 0.001). Mid-segment ventricular wall-thickening fraction offered 95% sensitivity (95% CI 88.7% to 98.4%), and 98.3% specificity (95% CI 90.9% to 1.0) with an optimal cut-off point of 0.349, yielding better results than systolic myocardial velocity, which provided 83% sensitivity (95% CI 74.2% to 89.8%), 90% specificity (95% CI 79.5% to 96.2%), and optimal cut-off point 4.47. The combination of systolic myocardial velocity and ventricular wall-thickening fraction offered 97% sensitivity (95% CI 91.5% to 99.4%) Mid-segment ventricular wall-thickening fraction might be suitable for the evaluation of patients with CAD.