P-92 Accuracy and Safety of Gd-DOTA Enhanced MRA Compared to Non-Enhanced TOF MRA At 3 Tesla in the Diagnosis of Non-Coronary Arterial Disease

Abstract

Background: The purpose of this study was to evaluate sensitive parameters of strain and strain rate in diastole, obtained five minutes after the termination of treadmill stress echocardiography for detecting ischemic myocardium. Method: 30 patients underwent treadmill stress test and speckle tracking followed by coronary angiography from March 2008 to August 2008. Strain and strain rate were evaluated in mid-LV segment from 3 apical views before and 5 minutes after the treadmill test. The values of longitudinal strain at the closure of aortic valve (A) and at the one third of diastolic period (B) were measured. The SI-diastolic index (SI-DI) was determined as (A-B)/A×100%. Time to peak strain (TPS), peak strain during isovolemic relaxation time (IVRTs) and peak strain rate during early diastole (ESR) were measured. Result: 32 territories with ischemia and 36 territories without ischemia were analyzed. At five minutes after the termination of treadmill, there was significant difference between ischemic and non-ischemic territories in TPS (380.7±79.3 vs 339.1±59.9, p = 0.019), IVRTs (10.8±7.6 vs 19.7±4.2, p < 0.001) and ESR (0.9±0.5vs1.4±0.5, p < 0.001). But there was no difference in SIDI (52.9±25.3 vs 38.8±22.6, p = 0.295). In multivariate anaylsis, ESR was an only independent parameter of ischemic territories. Conclusion: Delayed diastolic strain and strain rate imaging can differentiate ischemic and non-ischemic myocardium at five minutes after treadmill stress test. ESR can be sensitive parameter detecting ischemic myocardium.