PMID- 25920924
OWN - NLM
STAT- MEDLINE
DCOM- 20160620
LR  - 20161125
IS  - 2047-2412 (Electronic)
IS  - 2047-2404 (Linking)
VI  - 16
IP  - 10
DP  - 2015 Oct
TI  - Severe regional myocardial dysfunction by stress echocardiography does not 
      predict the presence of transmural scarring in chronic coronary artery disease.
PG  - 1074-81
LID - 10.1093/ehjci/jev096 [doi]
AB  - AIMS: Detection and correct localization of transmural lesions can be important 
      for optimal treatment of patients with chronic coronary artery disease (CAD). The 
      aim of the study was to investigate the ability of peak longitudinal ejection 
      strain (PLS) to detect the presence and extent of scar-tissue in CAD patients 
      with normal or near normal ejection fraction, in comparison to cardiac magnetic 
      resonance (CMR). METHODS AND RESULTS: Before coronary artery bypass grafting, 57 
      patients underwent late gadolinium enhancement (LGE) CMR and echocardiography at 
      rest and dobutamine stress (DS). According to the degree of LGE, segments were 
      allocated to groups of none, subendocardial (1-50%), subtotal (51-75%), and total 
      transmural scars (>75%). Dysfunctional segments were identified by PLS or wall 
      motion scores (WMS). The finding of normal/near normal resting WMS and PLS, 
      excellently identified segments without transmural LGE (AUC 94.0 CI 90.6-97.3 and 
      AUC 85.7 CI 79.0-92.3, respectively). However, the finding of akinesia did not 
      necessarily indicate transmural scarring. The negative predictive value was high 
      (99%, CI 98-100%) while the positive predictive value was low. Detection-rates 
      for subendocardial LGE were low. CONCLUSION: Normo- and slightly hypokinetic 
      myocardium by resting WMS or strain detects the absence of transmural scars. 
      However, the finding of severe hypo- and akinesia does not reliably predict 
      transmural scarring, with no improvement by the addition of DS. Detection of 
      predominant akinesia with less than two normo- or hypokinetic segments in the 
      territory of a high-grade coronary stenosis or occlusion, warrants further 
      examination by LGE-CMR.
CI  - Published on behalf of the European Society of Cardiology. All rights reserved. (c) 
      The Author 2015. For permissions please email: journals.permissions@oup.com.
FAU - Rosner, Assami
AU  - Rosner A
AD  - Cardiological Department, Division of Cardiothoracic and Respiratory Medicine, 
      University Hospital North Norway, Tromso 9038, Norway assami.rosner@unn.no.
FAU - Avenarius, Derk
AU  - Avenarius D
AD  - Cardiological Department, Division of Cardiothoracic and Respiratory Medicine, 
      University Hospital North Norway, Tromso 9038, Norway.
FAU - Malm, Siri
AU  - Malm S
AD  - University Hospital North Norway, Harstad, Norway Department of Clinical 
      Medicine, University of Tromso, Tromso, Norway.
FAU - Iqbal, Amjid
AU  - Iqbal A
AD  - Cardiological Department, Division of Cardiothoracic and Respiratory Medicine, 
      University Hospital North Norway, Tromso 9038, Norway.
FAU - Bijnens, Bart
AU  - Bijnens B
AD  - Department of Clinical Medicine, University of Tromso, Tromso, Norway 
      ICREA-Universitat Pompeu Fabra, Barcelona, Spain ICREA-Universitat Pompeu Fabra, 
      K.U. Leuven, Belgium.
FAU - Schirmer, Henrik
AU  - Schirmer H
AD  - Cardiological Department, Division of Cardiothoracic and Respiratory Medicine, 
      University Hospital North Norway, Tromso 9038, Norway Department of Clinical 
      Medicine, University of Tromso, Tromso, Norway.
LA  - eng
PT  - Journal Article
DEP - 20150428
PL  - England
TA  - Eur Heart J Cardiovasc Imaging
JT  - European heart journal. Cardiovascular Imaging
JID - 101573788
RN  - 0 (Contrast Media)
RN  - K2I13DR72L (Gadolinium DTPA)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Chronic Disease
MH  - Cicatrix/*pathology
MH  - Contrast Media
MH  - Coronary Artery Disease/*diagnostic imaging/pathology
MH  - *Echocardiography, Stress
MH  - Female
MH  - Gadolinium DTPA
MH  - Humans
MH  - Image Interpretation, Computer-Assisted
MH  - Magnetic Resonance Imaging
MH  - Male
MH  - Middle Aged
MH  - Myocardium/*pathology
MH  - Predictive Value of Tests
MH  - Prospective Studies
MH  - Reproducibility of Results
MH  - Sensitivity and Specificity
MH  - Stroke Volume
OTO - NOTNLM
OT  - Coronary artery disease
OT  - Detection of scar-tissue
OT  - Dobutamine-stress echocardiography
OT  - Strain-echocardiography
EDAT- 2015/04/30 06:00
MHDA- 2016/06/21 06:00
CRDT- 2015/04/30 06:00
PHST- 2015/01/28 00:00 [received]
PHST- 2015/03/25 00:00 [accepted]
PHST- 2015/04/30 06:00 [entrez]
PHST- 2015/04/30 06:00 [pubmed]
PHST- 2016/06/21 06:00 [medline]
AID - jev096 [pii]
AID - 10.1093/ehjci/jev096 [doi]
PST - ppublish
SO  - Eur Heart J Cardiovasc Imaging. 2015 Oct;16(10):1074-81. doi: 
      10.1093/ehjci/jev096. Epub 2015 Apr 28.