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Aims: Although two-dimensional dobutamine stress echocardiography(2D-DSE) is useful for the diagnosis of myocardial ischaemia, it requires the acquisition of multiple cross-sections at each stage. The introduction of new real-time three-dimensional echocardiography(RT3DE) offers rapid acquisition and 3D display of the entire left ventricle(LV). The purpose was to evaluate real-time three-dimensional-dobutamine stress echocardiography(RT3D-DSE) for the diagnosis of ischaemia using exercise 201Tl single-photon emission computed tomography(SPECT) as the reference standard, in comparison with 2D-DSE. Methods and results: We performed DSE in 56 consecutive patients who had undergone SPECT because of suspected ischaemia. 3D images by RT3DE were acquired from the apical window after the acquisition of cross-sectional images at every stage of 2D-DSE. Wall motion analysis in RT3DE was performed from anatomical images by cropping the acquired full volume data sets. Mean scanning time for adequate image acquisition at peak stress by RT3D-DSE was shorter than that by 2D-DSE(29± 4 vs. 68± 6 s, P< 0.0001). RT3DE provided adequate images at success rate of 92% at rest and 89% at peak stress, whereas two-dimensional echocardiography did at 94 and 90% , respectively. The sensitivity, specificity, and accuracy of RT3D-DSE for the detection of coronary artery disease are 86, 80, and 82% , respectively. Those of 2D-DSE are 86, 83, and 84% , respectively. There were no significant differences in the sensitivity, specificity, and accuracy between these two methods(P=1.000). Conclusion: RT3D-DSE offers rapid and simple acquisition of the entire LV wall motion and provides feasible and accurate assessment of myocardial ischaemia.
Aims: Although two-dimensional dobutamine stress echocardiography (2D-DSE) is useful for the diagnosis of myocardial ischaemia, it requires the acquisition of multiple cross-sections at each stage. The introduction of new real-time three-dimensional echocardiography (RT3DE) offers rapid acquisition and 3D display of the entire left ventricle (LV). The purpose was to evaluate real-time three-dimensional-dobutamine stress echocardiography (RT3D-DSE) for the diagnosis of ischaemia using exercise 201Tl single-photon emission computed tomography SPECT) as the reference standard, in comparison with 2D-DSE. Methods and results: We performed DSE in 56 consecutive patients who had undergone SPECT because of suspected ischaemia. 3D images by RT3DE were acquired from the apical window after the acquisition of cross- sectional images at every stage of 2D-DSE. Wall motion analysis in RT3DE was performed from anatomical images by cropping the acquired full volume data sets. Mean scanning time for adequat RT3D-DSE was shorter than that by 2D-DSE (29 ± 4 vs. 68 ± 6 s, P <0.0001). RT3DE provided adequate images at success rate of 92% at rest and 89% at Peak sensitivity, two-dimensional echocardiography did at 94 and 90% respectively. The sensitivity, specificity, and accuracy of RT3D-DSE for the detection of coronary artery disease are 86, 80, and 82%, respectively. There were no significant differences in the sensitivity, specificity, and accuracy between these two methods (P = 1.000). Conclusion: RT3D-DSE offers rapid and simple acquisition of the entire LV wall motion and provides feasible and accurate assessment of myocardial ischaemia.