Abstract 2082: Comparative Diagnostic Accuracy Between Tri-plane and full volume Three-Dimensional Dobutamine Stress Echocardiography for Detecting Coronary Artery Disease
Background: Although real-time 3D echocardiography (RT3DE) is useful for the delineation of 3-dimensional extent and severity of stress induced wall motion abnormalities during dobutamine stress echocardiography (DSE), comparative diagnostic accuracy between multi-plane RT3DE and full-volume RT3DE for detecting significant coronary artery disease (CAD) is not known.
Methods: To address this, we acquired both tri-plane echocardiography and full-volume datasets (3V, GE) from the apical window at rest and peak dose of DSE In 68 patients with known or suspected CAD. In tri-plane mode, matrix array transducer allowed the simultaneous visualization of apical 4-, 2- and 3-chamber views. From full-volume datasets, 9 equidistant 2D short axis (SAX) images were extracted and simultaneously displayed (9-slice mode). Regional wall motion was assessed visually using side-by-side comparison in both methods.
Results: Adequate data in both modes were obtained in 66 patients (feasibility: 97%). Heart rate increased from 65±12 bpm to 131±22 bpm (70% of age-predicted maximal heart rate). Abnormal findings (new or worsened wall motion abnormalities or fixed wall motion abnormalities) were observed in 34 patients by tri-plane mode and 25 patients by 9-slice mode. Subsequent coronary angiography showed significant coronary artery stenosis in 28 patients and 44 out of 198 vessels. In patient basis, sensitivity was not different, but specificity was significantly higher in 9-slice mode (90%) compared to tri-plane mode (71%, p<0.05). Diagnostic accuracy for detecting right coronary artery disease was also significantly higher in 9-slice mode (92% vs. 80%, p<0.05).
Conclusions: Multiple 2D SAX assessment of wall motion from full-volume datasets could reduce false positive findings, which appears only one cutting plane. True orthogonal SAX views along with long axis also improve detection of basal wall motion abnormality making this mode useful modality during DSE.