Diagnostic Value of Regional Wall Motion Abnormalities on Resting Transthoracic Echocardiography for Coronary Artery Disease

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques Pub Date : 2024-11-14 DOI:10.1111/echo.70031

Jess Hatfield, Michael D. Woods, Alex Pham, Scott Mayo, Laith Wahab, Kendall Hammonds, Vinh Nguyen, Robert J. Widmer

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引用次数: 0

Abstract

Purpose

Regional wall motion abnormality (RWMA) on transthoracic echocardiography (TTE) is used as a clinical decision-making tool to assess systolic function, but there is limited data regarding the validity of this tool to predict obstructive coronary artery disease (CAD). This study evaluates the utility of RWMA on TTE for detecting obstructive CAD in patients with no prior CAD history.

Methods

We retrospectively reviewed charts of adults who underwent resting TTE and coronary angiography within 30 days, analyzing RWMA in relation to angiographic luminal stenosis.

Results

Among 754 patients (mean age 62, 60% male), TTE sensitivity varied with timing relative to angiography: 68.7% after angiography versus 49.5% before. In ST-elevation myocardial infarction (STEMI) patients (n = 126 after vs. n = 4 before), sensitivity was 89.8%. RWMA correlated with CAD severity, particularly in STEMI cases.

Conclusions

TTE specificity remains high, but sensitivity varies significantly by timing, with the highest sensitivity in STEMI patients. These findings could refine decision-making in uncertain STEMI cases, supporting TTE as a valuable adjunctive diagnostic tool.

Abstract Image

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静息经胸超声心动图区域壁运动异常对冠状动脉疾病的诊断价值

目的：经胸超声心动图（TTE）上的区域室壁运动异常（RWMA）被用作评估收缩功能的临床决策工具，但有关该工具预测阻塞性冠状动脉疾病（CAD）有效性的数据却很有限。本研究评估了 TTE 上的 RWMA 对检测既往无 CAD 病史患者的阻塞性 CAD 的效用：我们回顾性地查看了 30 天内接受静息 TTE 和冠状动脉造影的成人病历，分析了 RWMA 与血管造影管腔狭窄的关系：在 754 名患者（平均年龄 62 岁，60% 为男性）中，TTE 的敏感性随血管造影的时间而变化：血管造影后为 68.7%，血管造影前为 49.5%。在ST段抬高型心肌梗死（STEMI）患者中（造影后126人，造影前4人），敏感性为89.8%。RWMA与CAD严重程度相关，尤其是在STEMI病例中：结论：TTE 的特异性仍然很高，但敏感性因时间不同而有很大差异，在 STEMI 患者中敏感性最高。这些发现可以完善不确定 STEMI 病例的决策，支持将 TTE 作为有价值的辅助诊断工具。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques 医学-心血管系统

CiteScore

2.40

自引率

6.70%

发文量

211

审稿时长

3-6 weeks

期刊介绍： Echocardiography: A Journal of Cardiovascular Ultrasound and Allied Techniques is the official publication of the International Society of Cardiovascular Ultrasound. Widely recognized for its comprehensive peer-reviewed articles, case studies, original research, and reviews by international authors. Echocardiography keeps its readership of echocardiographers, ultrasound specialists, and cardiologists well informed of the latest developments in the field.