Abstract
Three methods for assessment of fractional area change (FAC) and conventional versus cross-sectional segmentation were compared under conditions known to occur frequently during stress echocardiography. Quantitative analysis of 80 echocardiograms obtained from healthy subjects, patients with left ventricular (LV) dysfunction and after coronary artery bypass grafting included segmental and cross-sectional FACs by the centroid method with fixed and floating reference and a method with floating external reference. All segmental and cross-sectional FACs were equally sensitive to LV dysfunction, and segmental FACs failed to accurately predict the location of coronary lesions. The centroid method with floating reference and cross-sectional FACs were the least affected by surgery induced intrathoracic heart motion. In moderate to severe LV dysfunction FAC by the centroid method with floating reference and cross sections were rarely within normal limits. Cross-sectional FACs may prove to be useful in stress echocardiography. For viability studies segmental FAC by fixed reference appears to be the method of choice.
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Hoffmann R, Lethen H, Marwick TH, et al. Analysis of interinstitutional observer agreement in interpretation of dobutamine stress echocardiograms. J Am Coll Cardiol 1996; 27: 330-336.
Picano E. Stress echocardiography. From pathophysiological toy to diagnostic tool. Circulation 1992; 85: 1604-1612.
Parisi AF, Moynihan BS, Folland ED, Feldman CL. Quantitative detection of regional left ventricular contraction abnormalities by two-dimensional echocardiography. II. Accuracy in coronary artery disease. Circulation 1981; 63: 761-767.
Mor AV, Vignon P, Koch R, et al. Segmental analysis of color kinesis images: new method for quantification of the magnitude and timing of endocardial motion during left ventricular systole and diastole. Circulation 1997; 95: 2082-2097.
Leischik R, Kuhlmann C, Bruch C, Jeremias A, Buck T, Erbel R. Reproducibility of stress echocardiography using intravenous injection of ultrasound contrast agent. Int J Card Imaging 1997; 13: 387-394.
Spencer KT, Bednarz J, Rafter PG, Korcarz C, Lang RM. Use of harmonic imaging without echocardiographic contrast to improve two-dimensional image quality. Am J Cardiol 1998; 82: 794-799.
Ingels NB, Daughters GTI, Stinson EB, Alderman EL. Evaluation of methods for quantitating left ventricular wall motion in man using myocardial markers as a standard. Circulation 1980; 61: 966-979.
Force T, Bloomfield P, O'Boyle JE, Khuri SF, Josa M, Parisi AF. Quantitative two-dimensional echocardiographic analysis of regional wall motion in patients with perioperative myocardial infarction. Circulation 1984; 70: 233-241.
Assmann PE, Slager CJ, van der Borden SG, Sutherland GR, Roelandt JR. Reference systems in echocardiographic quantitative wall motion analysis with registration of respiration. J Am Soc Echocardiogr 1991; 4: 224-234.
Bates JR, Ryan T, Rimmerman CM, et al. Color coding of digitized echocardiograms: Description of a new technique and application in detecting and correcting for cardiac translation. J Am Soc Echocardiogr 1994; 7: 363-369.
Schiller NB, Shah PM, Crawford M, DeMaria A, Devereux R, Feigenbaum H. Recommendations for quantification of the left ventricle by two-dimensional Echocardiography. J Am Soc Echocardiogr 1989; 2: 358-367.
Lang RM, Vignon P, Weinert L, et al. Echocardiographic quantification of regional left ventricular wall motion with color kinesis [see comments]. Circulation 1996; 93: 1877-1885.
Force T, Bloomfield P, O'Boyle JE, et al. Quantitative two-dimensional echocardiographic analysis of motion and thickening of the interventricular septum after cardiac surgery. Circulation 1983; 68: 1013-1020.
Sawada SG, Segar DS, Ryan T, et al. Echocardiographic detection of coronary artery disease during dobutamine infusion. Circulation 1991; 83: 1605-1614.
Perez JE, Waggoner AD, Davila RV, Cardona H, Miller JG. On-line quantification of ventricular function during dobutamine stress echocardiography. Eur Heart J 1992; 13: 1669-1676.
Broderick TM, Bourdillon PD, Ryan T, Feigenbaum H, Dillon JC, Armstrong WF. Comparison of regional and global left ventricular function by serial echocardiograms after reperfusion in acute myocardial infarction. J Am Soc Echocardiogr 1989; 2: 315-323.
Ali SM, Egeblad H, Steensg\0ard-Hansen FV, Saunam\:aki K, Carstensen S, Hauns\/o S. Echocardiographic assessment of regional and global left ventricular function: wall-motion scoring in parasternal and apical views versus apical views alone. Echocardiography 1997; 14: 313-320.
Bonarjee V, Carstensen S, Caidahl K, Nilsen DW, Edner M, Berning J. Attenuation of left ventricular dilatation after acute myocardial infarction by early initiation of enalapril therapy. Am J Cardiol 1993; 72: 1004-1009.
Vitarelli A, Luzzi MF, Penco M, Fedele F, Dagianti A. On-line quantitative assessment of left ventricular filling during dobutamine stress echocardiography: a useful addition to conventional wall motion scoring. Int J Cardiol 1997; 59: 57-69.
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Carstensen, S., Hoest, U., Kjoeller-Hansen, L. et al. Comparison of methods of fractional area change for detection of regional left ventricular dysfunction. Int J Cardiovasc Imaging 16, 257–266 (2000). https://doi.org/10.1023/A:1026541122010
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DOI: https://doi.org/10.1023/A:1026541122010