Dobutamine-Atropine Stress Echocardiography

Abstract

on wall motion analysis, a subjective method for evaluation of regional LV function, and a reduction in systolic endocardial excursion or myocardial thickening during increasing stress has been the universal diagnostic criterion for stress-induced ischemia [1, 5, 6] . Stress echocardiography has gained widespread use in several countries and a huge amount of experience has accumulated in the literature over the past 10–15 years. In spite of several reports of high diagnostic accuracies with regard to the presence of CAD, it has become evident that the interpretation criteria are vaguely defi ned and in case of dobutamine-atropine stress echocardiography (DASE), that the variation in test interpretation between institutions is substantial [7] . This is a problem with regard to a widespread use of the test because a high reproducibility is mandatory when results from one centre are to be extrapolated to another. In the search for a more objective and reproducible interpretation of the 2D recordings obtained during DASE, the substudies of this thesis were conducted with the following objectives: (i) To describe global and regional systolic LV function in healthy subjects undergoing DASE. (ii) To identify the cornerstones of qualitative DASE analysis and to assess the reproducibility and diagnostic performance of strictly defi ned diagnostic criteria. (iii) To investigate the usefulness of certain quantitative parameters of systolic LV function in the appreciation of stress-induced ischemia during DASE.