Abstracts S171 Eur J Echocardiography Abstracts Supplement, December 2006 3-D ECHO 1004 Three dimensional parametric contractility assessment during dobutamine stress echocardiography at patients suspected of coronary artery disease P. Scislo 1 ; J. Kochanowski 1 ; R. Piatkowski 1 ; G. Opolski 1 1 Warsaw Medical University, Cardiology Dept., Warsaw, Poland Background: The aim of the study was to assess value of 3D quantification used during diagnostic dobutamine stress echocardiography (dDASE 3D) at patients (pts) suspected of coronary artery disease (CAD). Methods: We analyzed 40 patients (pts) referred to dDASE 3D before planned coronary angiography. Stress echo was done using standard protocol (0- 10-20-30-40 - mcg/min dobutamine + atropine if needed in 5-3-3-3 min. in- tervals) on Philips iE33 with 3D Qlab advanced software. During base as- sessment and maximal dobutamine infusion 2D (dDASE 2D) and 3D (dDASE 3D) full volume were recorded. First observer described LV contractility us- ing 17 segment model as normo, hipo, akinesis and dyskinesis in 2D. Sec- ond independent observer, reconstructed 17 segments 3D LV shape. Con- tractility of each segment were analyzed by following 3D parameters: seg- ment contractility fraction/SCF - change of segment thickness during sys- tole-diastole, segment movement fraction/SMF - inward, systolic movement of segments and time of contraction, synchronicity time/sT - segment’s time contraction. All patients had coronary angiogram, as a significant >=70% oclussion was defined (>50% occlusion in the left main coronary artery). Results: We analyzed diagnostic values of 2D dDASE and dDASE 3D in comparison to results of coronary angiogram. Conclusion: Because of the real 3D analysis DASE 3D has better diagnos- tic value than standard 2D assessment in identification of patients with coro- nary artery disease. The parametric assessment was very helpful in border- line segment assessment (e.g. hipoakinetic) when it was difficult to qualify segment unambiguously. Table 1. 2D vs 3D dDASE assessment Sensitivity Specificity PPV NPV 3D 90% 90% 90% 90% 2D 85% 90% 89% 86% 1005 Transthoracic real-time three-dimensional bicycle stress echocardiography- Comparison of this new technique with conventional two-dimensional bicycle stress echo H. Lethen 1 ; H.P. Tries 1 ; F. Zuercher 1 ; H. Lambertz 1 1 Deutsche Klinik fuer Diagnostik, Abt. Kardiologie, Wiesbaden, Germany Purpose: Two-dimensional bicycle stress echo (2-D-BSE) is a safe and ac- curate method for diagnosing coronary artery disease(CAD), but adequate image acquisition at peak stress remains a problem due to motion artefacts and hyperventilation. Newly introduced three-dimensional echo allows rapid image acquisition of the entire left ventricle using an apical imaging plane. The aim of the study was 1) to evaluate the diagnostic accuracy of three- dimensional bicycle stress echo (3-D BSE) and 2) to answer the question if image acquisition is facilitated by this new approach. Methods: 35 consecutive patients (pts) with clinically suspected CAD sched- uled for coronary angiography were investigated. In all pts 2-D BSE and 3-D BSE were performed in a randomized order by one experienced investigator; there was a time delay of at least 2 hours between the first and the second BSE. 2-D BSE images were acquired from 2 parasternal and 2 apical image planes, 3-D BSE images from the apical window. Analysis of 3-D BSE was performed from anatomical images by cropping the full volume data sets. Results: Mean time for adequate image acquisition at peak stress was shorter for 3-D BSE than for 2-D BSE (26±6 s compared to 78±9 s, p<0.001). Im- age quality at rest and peak stress was sufficient to evaluate all three coro- nary territories in 92% in 3-D BSE and in 96% in 2-D BSE. There was no significant difference regarding sensitivity and specificity of 3-D BSE (89 and 92%) compared with 2-D BSE (92 and 94%), to detect CAD. Conclusions: In bicycle stress echo 3-D image acquisition is rapid and ac- curate and allows reproducible asessment of myocardial ischemia. The short- ening of the acquisition time in stress echocardiography makes this tech- nique a promising and useful tool for daily clinical practice. 1006 Real-time three-dimensional dobutamine stress echocardiography in detection of myocardial ischemia - validation with coronary angiography G. Giannopoulos 1 ; E. Christoforatou 1 ; C. Aggeli 1 ; G. Roussakis 1 ;  C. Kokkinakis 1 ; S. Brili 1 ; C. Stefanadis 1 1 University of Athens Medical School, Hippokration Hospital, 1st Cardiology Dept., Athens, Greece Objective: The goal of the present study was to compare real-time three-dimen- sional (RT3DE) to two-dimensional dobutamine stress echocardiography (2DE) for detection of myocardial ischemia, with angiographic validation of the results. Methods: 56 patients (age 64.5±6.2, 38 males), referred for coronary an- giography, were examined by 2DE and RT3DE during the same dobutamine stress protocol with echo-contrast medium infusion for left-ventricle opacifi- cation [see Figure: cropped 3D and 2D image at peak stress in a patient with significant left anterior descending artery (LAD) disease]. Results: All patients completed the protocol uneventfully. Mean acquisition time for the necessary views to evaluate all segments was 26.3±2.5 sec for RT3DE and 58.8±3.7 sec for 2DE (p<0.001). At peak stress, RT3DE reported higher wall-motion score index (1.25±0.24 by 2DE, 1.30±0.27 by RT3DE; p=0.014). We compared the regional wall-motion score for the four apical segments at peak stress which was 1.35±0.55 by 2DE and 1.52±0.69 by RT3DE (p=0.003). The diagnostic parameters of 2DE vs RT3DE were: sensi- tivity 73% vs 78%, specificity 93 vs 89% and overall accuracy 86% vs 85%, respectively. In the LAD territory, in particular, where RT3DE reported higher apical wall-motion scores, it showed a tendency towards higher sensitivity (85% vs 78%), although this difference did not achieve statistical significance. Conclusion: We report that RT3DE identifies more readily wall-motion ab- normalities in the apical region than 2DE, which may explain the tendency towards higher sensitivity in the LAD territory. We validate RT3DE results using angiography as reference and our findings indicate diagnostic equiva- lence to 2DE, with the advantage of significantly shorter acquisition times. ORAL SESSION New modalities of stress echocardiography Friday, 8 December 2006, 16:30–18:00 Location: Novak Eur J Echocardiography Abstracts Supplement, December 2006 Downloaded from https://academic.oup.com/ehjcimaging/article-abstract/7/suppl_1/S171/2402142 by guest on 18 June 2020