Left ventricular transient ischemic dilation during dobutamine stress echocardiography predicts multi-vessel coronary artery disease

SummaryBackgroundWe sought to explore the value of stress-induced transient ischemic dilation (TID) of the left ventricle during dobutamine stress echocardiography, to predict the presence of multi-vessel coronary artery disease as seen by coronary angiography.MethodsWe enrolled 60 patients referred to our stress echocardiography labs with ischemic-type chest pain or other symptoms suggestive of myocardial ischemia. All patients underwent resting and stress echocardiography employing the standard dobutamine stress protocol. TID ratio was defined as the ratio of left ventricular end-diastolic volume or end-systolic volume measured at peak stress, to that measured at rest (EDV ratio and ESV ratio, respectively). We enrolled 20 consecutive patients with normal response (control group) who were subsequently evaluated to develop normal limits for TID ratio, and 40 patients with ischemic response (study group) that comprised 20 consecutive patients without TID (group A) and 20 consecutive patients with TID (group B). Patients then underwent coronary angiography.ResultsBoth EDV ratio and ESV ratio were significantly higher in groups A and B as compared to the control group (P