The Value Of ATE In Detection Of Coronary Heate Disease And Viable Myocardium

Objective To approach the sensitivity and security of adenosine stress echocardiography(ATE) in the diagnosis of CAD, and evaluate the diagnostic value of ATE in detection of myocardial viability.Materials and Motheds 59 patients were enrolled in the study. Group I:27 patients underwent coronary angiography and proved to be coronary artery disease(CAD), received ATE:adenosine persistent injection for 6 minutes. The injection dose are 110ug/kg/min-3min and 140ug/kg/min-6min. During the course of injection, the changes of electrocardiography in ST-T segments and echocardiography in walls motion were observed as evidences to speculate culprit coronary artery. The results were compared with them stemming from coronary angiography, then assessed the diagnostic potiential of ATE in CAD. Group II:15 patients with resting dyssynergy and walls motion abnormality, due to previous myocardial infarction, underwent ATE. The dose were 90ug/kg/min-3min and 110ug/kg/min-3min. The improvements of segments motion and systolic thickening were considered as myocardial viability detected by ATE. Gold standard is the data of improvement in walls motion from follow-up 3-5 months later. Compared with gold-standard, sensitivity of ATE in detection of myocardial viability was evaluated. Group III:17 persons with normal results of coronary angiography and abnormal types of ST-T in electrocardiography were enrolled as control group. Adenosine was persistently injected for 6 minutes, in the meanwhile the changes of electrocardiography and walls motion in echocardiography were observed.Results 1. Of the 27 patients with injection of adenosine, in groupâ… ,22 patients experienced decrease of walls segments motion; in group III,15 cases'walls motion improved extensively and 2 cases were witnessed decreased segments in walls motion. So the overall sensitivity and specificity of ATE in diagnosis of CAD were 81.5% and 88.2% respectively. The sensitivity of detecting one. two and three coronary artery disease are 72.7%,88.9%,85.7%.2. In group II, ATE detected 47 segments as myocardial viability in the 15 patients. Compared with gold standard, the sensitivity of identification of myocardial viability was 90.4%.3. In group III, there were 2 cases suffering from decrease of walls motion in ATE. While most of the cases(14/17) experiences the improvement of ST-T in electrocardiography, especially the recovery of T waves.Conclusion Adenosine stress echocardiography is a safe and effective mothed in the diagnosis of CAD and detection of myocardial viability. At the same time, ATE is a significant supplement of current methods in the diagnosis of CAD.