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Improving ischemia diagnosis: 3D speckle-tracking stress echocardiography.

Session Poster session 4

Speaker Marina Pascual Izco

Event : EuroEcho 2019

  • Topic : imaging
  • Sub-topic : Stress Echocardiography
  • Session type : Poster Session

Authors : M Pascual Izco (Madrid,ES), E Casas Rojo (Madrid,ES), A Kardos (Milton Keynes,GB), GL Alonso Salinas (Madrid,ES), A Garcia Martin (Madrid,ES), R Hinojar Baydes (Madrid,ES), JM Monteagudo Ruiz (Madrid,ES), JD Sanchez Vega (Madrid,ES), J Ramos Jimenez (Madrid,ES), JJ Jimenez Nacher (Madrid,ES), S Ruiz (Madrid,ES), JL Moya (Madrid,ES), JL Zamorano Gomez (Madrid,ES), C Fernandez-Golfin Loban (Madrid,ES)

M Pascual Izco1 , E Casas Rojo1 , A Kardos2 , GL Alonso Salinas1 , A Garcia Martin1 , R Hinojar Baydes1 , JM Monteagudo Ruiz1 , JD Sanchez Vega1 , J Ramos Jimenez1 , JJ Jimenez Nacher1 , S Ruiz1 , JL Moya1 , JL Zamorano Gomez1 , C Fernandez-Golfin Loban1 , 1Ramón y Cajal University Hospital, Cardiology - Madrid - Spain , 2Milton Keynes Hospital NHS Trust - Milton Keynes - United Kingdom of Great Britain & Northern Ireland ,


Background: 2D stress echocardiography (SE) is based in the visual analysis of wall motion abnormalities and it requires a trained operator. This operator-dependence has promoted the search for a semiautomatic method to reduce SE limitations and improve test accuracy. The aim of this study was to evaluate the value of 3D speckle tracking (3DSTE) in SE in patients with chest pain.

Methods: 44 consecutive patients with chest pain and pathological findings on CCTA (>50% stenosis or high calcium score (>400 HU) with undetermined severity) were included. These patients underwent SE with acquisition of 3DSTE at rest and at peak stress.

Results: Mean age was 63.9±9.9 years. 90% were men.  The images of the 44 patients were processed with automatic tracking and manual corrections. 11 patients developed inducible ischaemia during SE. Patients with ischaemic response showed significant reductions in 3D area strain (AS) compared to resting values. The 33 patients without inducible ischaemia showed, however, a significant increase in this parameter. Results are shown in table 1.

Conclusion: 3D area strain SE could help to identify patients with inducible ischemia. However, further studies are need to confirm these data.

Ischemia + (n=11)

Ischemia - (n=33)


2D LVEF rest

57.2; 5.5

61.4; 6.0


2D LVEF peak stress

56.9; 11.7

70.0; 9.0


3D LVEF at rest

54.3; 6.9

64.3; 9.7


3D LVEF peak stress

51.9; 22.5

66.0; 8.6


AS rest

38.3; 5.1

40.4; 5.7


AS peak stress

37.2; 11.3

43.6; 7.2


LVEF: left ventricle ejection fracion; AS: area strain.

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