Doppler tissue imaging combined with Dobutamine stress echocardiography for evaluation of left ventricular compensation in elderly patients with coronary artery disease

Abstract

Objective To explore the clinical value of using Doppler tissue ultrasonography(TDI)combined with dobutamine stress echocardiography(DSE)to diagnose left ventricular compensation in elderly patients with coronary artery disease(CAD). Methods From Jan.2011 to Dec.2013, ninety-eight elderly patients with suspected coronary heart disease who were diagnosed in BEI JING hospital and XUANWU hospital underwent the echocardiography examination using DSE + TDI, and mean velocity of mitral annulus on different dobutamine stress dose in systolic and diastolic period were measured.Then all patients were performed coronary angiography(CAG)in 2 weeks.Based on the CAG results, patients were divided into the CAD group and normal group. Results There were 51 patients in the CAD group and 47 cases in the control group.The baseline there was no significant difference in the mean systolic peak velocity, diastolic peak velocity and late diastolic peak velocity between the two groups.Sa(9.6±1.4 vs.9.7±1.9); Ea(14.2±2.5 vs.14.4±2.9); Aa(9.3±1.7 vs.9.2±1.9). However, systolic and early diastolic velocity of mitral annulus was lower in CAD than that in normal subjects at 20 μg·kg-1·min-1 dose.There was no significant difference in the late diastolic velocity of mitral annulus at 40 μg·kg-1·min-1 dose between CAD and normal subjects. Conclusions In elderly patients with coronary artery disease, left ventricular systolic and diastolic compensation is reduced, which could be easily found when dubotamine is at 20 μg·kg-1·min-1 dose.Doppler tissue imaging with dubotamine stress echocardiography can be used for diagnosing compensation of cardiac function in elderly patients with coronary artery disease. Key words: Coronary artery disease; Dobutamine stress; Cardiac function; Elderly