アライ コウタロウ   ARAI Kotaro
  新井 光太郎
   所属   医学部 医学科(東京女子医科大学病院)
   職種   助教
論文種別 原著
言語種別 英語
査読の有無 査読あり
表題 Temporal analysis of regional strain rate during adenosine triphosphate stress before and after percutaneous coronary interventions.
掲載誌名 正式名:Heart and vessels
略  称:Heart Vessels
ISSNコード:09108327/16152573
掲載区分国外
出版社 Springer Japan
巻・号・頁 30(3),309-317頁
著者・共著者 GUNJI Kazue, ATUSHI TAKAGI*, ARAI Kotaro, ASHIHARA Kyomi, Nobuhisa Hagiwara
発行年月 2015/05
概要 Regional myocardial ischemia is thought to be characterized by diastolic dysfunction. We aimed to clarify whether temporal analysis of strain rate (SR) index derived from two-dimensional speckle-tracking echocardiography (2DTE) can assess the regional myocardial ischemia or not. Forty-two patients with significant coronary stenoses were referred for percutaneous coronary intervention (PCI). 2DTE was performed before and a day after PCI. Time from aortic valve closure to peak early diastolic longitudinal SR ∆(TAVC-E SR) was measured both at baseline and during adenosine triphosphate (ATP) infusion. TAVC-E SR was calculated as TAVC-E SR during ATP infusion subtracted by TAVC-E SR at baseline. In forty-five target ischemic regions, TAVC-E SR at baseline was significantly longer than that of control regions (166 ± 28 vs. 136 ± 32 ms, P < 0.0001). TAVC-E SR in target ischemic regions significantly prolonged during ATP stress to 221 ± 37 ms (P < 0.0001), while it did not change in control regions. Immediately after PCI, TAVC-E SR in target regions significantly decreased to 135 ± 27 ms, P < 0.0001 without prolongation during ATP stress. Receiver operating characteristic curves demonstrated that ∆TAVC-E SR could assess regional myocardial ischemia by a cutoff criterion of 14 ms with sensitivity of 93% and specificity of 95%. 2DTE-derived TAVC-E SR significantly increased during ATP stress only in ischemic myocardium. This phenomenon disappeared immediately after PCI. Temporal analysis of TAVC-E SR appeared to be useful to assess the regional myocardial ischemia.
DOI 10.1007/s00380-014-0491-x
PMID 24633495