TY - JOUR
TI - Detection of high-burden coronary artery disease by exercise-induced changes of the E/E' ratio
AU - Tsougos, E.
AU - Paraskevaidis, I.
AU - Dagres, N.
AU - Varounis, C.
AU - Panou, F.
AU - Karatzas, D.
AU - Trapali, X.
AU - Iliodromitis, E.
AU - Kremastinos, D.T.
JO - The International Journal of Cardiovascular Imaging (formerly Cardiac Imaging)
PY - 2012
VL - 28
TODO - 3
SP - 521-530
PB - 
SN - 1569-5794
TODO - 10.1007/s10554-011-9840-3
TODO - dipeptidyl carboxypeptidase inhibitor, adult;  angiocardiography;  article;  body mass;  cardiovascular parameters;  controlled study;  coronary artery disease;  coronary artery obstruction;  diagnostic test accuracy study;  diagnostic value;  Doppler echocardiography;  early diastolic transmitral velocity to early diastolic tissue velocity ratio;  exercise;  exercise echocardiography;  female;  heart left ventricle function;  heart rate;  heart scintiscanning;  heart ventricle wall motion;  human;  hypertension;  major clinical study;  male;  receiver operating characteristic;  sensitivity and specificity;  stress echocardiography;  thorax pain;  two dimensional echocardiography, Aged;  Angina Pectoris;  Chi-Square Distribution;  Coronary Angiography;  Coronary Artery Disease;  Coronary Circulation;  Diastole;  Echocardiography, Doppler, Color;  Echocardiography, Doppler, Pulsed;  Echocardiography, Stress;  Exercise Test;  Female;  Greece;  Humans;  Logistic Models;  Male;  Middle Aged;  Multivariate Analysis;  Myocardial Perfusion Imaging;  Odds Ratio;  Predictive Value of Tests;  Sensitivity and Specificity;  Severity of Illness Index;  Stroke Volume;  Tomography, Emission-Computed, Single-Photon;  Ventricular Function, Left
TODO - To investigate whether exercise-induced changes of the E/E' average ratio can detect highburden coronary artery disease (CAD) in patients with chest pain and normal left ventricular (LV) systolic function. The study population consisted of 359 patients admitted for chest pain (59.8 ± 9.8 years, 75% male). Patients underwent exercise echocardiography, scintigraphy and coronary angiography. The average of the lateral and septal ratios of early diastolic transmitral velocity to early diastolic tissue velocity (E/E') at baseline and immediately after exercise was calculated. Exercise induced wall motion abnormalities were also calculated. Coronary angiography showed flow limiting CAD in 238 patients (66%). The exercise-induced changes of E/E' average ratio had a sensitivity of 87.3% and a specificity of 75.2% for detection of flow limiting CAD, whereas myocardial scintigraphy showed 79.2% sensitivity and 80.1% specificity and exercise induced wall motion abnormalities had a sensitivity of 74.3% and a specificity of 66.9%. Likelihood ratio chi square showed an incremental value of the exercise-induced changes of E/E' average ratio over regional perfusion technique (from 121.37 to 194.15, P<0.001) and over wall motion abnormalities (from 57.03 to 146.50, P<0.001). The exercise-induced change of the E/E' average ratio detects flow limiting CAD in patients with chest pain and normal LV systolic function showing an incremental value over regional perfusion technique and wall motion abnormalities. © Springer Science+Business Media, B.V. 2011.
ER -