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Submitted: 26 June 2008
HERDIN Record #: PCHRD062808020614

Left atrial volume index response during dobutamine stress echocardiography among patients with or without ischemic myocardium .

Raul Jara,
Edwin S. Tucay,
Romeo Santos,
Ronald E. Cuyco

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Background ÃÆ'Æ'Æ’ÃÆ'†â€™ÃÆ'Æ'â€Ã...¡ÃÆ'‚¢ÃÆ'Æ'Æ’ÃÆ'¢â‚¬Ã...¡ÃÆ'Æ'¢ÃÆ'¢â‚¬Ã...¡ÃÆ'‚¬ÃÆ'Æ'Æ’ÃÆ'¢â‚¬Ã...¡ÃÆ'Æ'¢ÃÆ'¢â€Ã...¡Ã‚¬ÃÆ'‚ Change in diastolic function is one of the early hemodynamic manifestations in patients with myo-cardial ischemia. Since left atrial volume index (LAVI) has been strongly correlated with left ventricular dysfunction, by inference it can be an indicator of a myocardial ischemia during stress echocardiography. The primary objective of the study is to determine the LAVI response during the dobutamine stress echocardiography (DSE) of patients with or without myocardial ischemia, particularly by looking at the difference between baseline and peak LA volume indices during the procedure.

Methods and Results ÃÆ'Æ'Æ’ÃÆ'†â€™ÃÆ'Æ'â€Ã...¡ÃÆ'‚¢ÃÆ'Æ'Æ’ÃÆ'¢â‚¬Ã...¡ÃÆ'Æ'¢ÃÆ'¢â‚¬Ã...¡ÃÆ'‚¬ÃÆ'Æ'Æ’ÃÆ'¢â‚¬Ã...¡ÃÆ'Æ'¢ÃÆ'¢â€Ã...¡Ã‚¬ÃÆ'‚ This prospective cross-sectional study enrolled forty-four (44) patients who underwent DSE at the Philippine Heart Center Non-invasive Laboratory from June 1, 2005 to August 31, 2005. Baseline 2-D echocardiograph with Doppler study including diastolic function assessment was done on each patient. LA volume as determined by the biplane area-length method was taken both before and at the peak of the procedure.
There were 31 patients with normal wall motion (NWM) and 13 patients with abnormal motion (AWM). The mean peal LAVI in patients with AWM (22.83 + 10.02 cc/m2) is higher compared to the mean peak LAVI in patients with NWM (17.77+ 5.77 cc/m2), and the difference between two groups is statistically significant (p=0.000). There is a significant drop in LAVI from baseline to peak of dobutamine infusion in patients with NWM (-5.13 + 5.68; p=000). There is no significant change in LAVI from baseline to peak of dobutamine infusion in patients with AWM (+0.665 + 6.58;p=0.729). Their difference is statistically significant (p=0.005). Seven (7) of the thirteen (13) patients who had abnormal wall motion on DSE eventually underwent coronary angiography and all of them were proven to have coronary artery disease.

Conclusion ÃÆ'Æ'Æ’ÃÆ'†â€™ÃÆ'Æ'â€Ã...¡ÃÆ'‚¢ÃÆ'Æ'Æ’ÃÆ'¢â‚¬Ã...¡ÃÆ'Æ'¢ÃÆ'¢â‚¬Ã...¡ÃÆ'‚¬ÃÆ'Æ'Æ’ÃÆ'¢â‚¬Ã...¡ÃÆ'Æ'¢ÃÆ'¢â€Ã...¡Ã‚¬ÃÆ'‚ LAVI change during DSE therefore, could be an important indicator in the detection of CAD. (Author)

Publication Type
Journal
Publication Sub Type
Journal Article, Original
Title
Philippine Heart Center Journal
Frequency
Quarterly
Publication Date
July-September 2006
Volume
12
Issue
3
Page(s)
1-4

Objectives

General: To assess the LA volume index response during Dobutamine stress echocardiography of patients with or without myocardial ischemia.

Specific:
1. To determine the baseline LA volume index among patients with or without myocardial ischemia.
2. To determine the peak LA volume index response during Dobutamine stress echocardiography (DSE) of patients with or without myocardial ischemia.
3. To determine the difference between baseline and peak LA volume indices during DSE of patients with or without myocardial ischemia.
4. To determine if other co-morbid factors such as baseline diastolic dysfunction, diabetes mellitus, hypertension and smoking are associated with wall motion abnormality.

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Philippine Council for Health Research and Development Library Abstract Print Format (Request Document)

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