タカギ アツシ   ATUSHI TAKAGI
  高木 厚
   所属   医学部 医学科(東京女子医科大学病院)
   職種   講師
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