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Left atrial volume index response during dobutamine stress echocardiography among patients with or without ischemic myocardium.


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Publication Information

Publication Type
Publication Sub Type
Journal Article, Original
Philippine Journal of Cardiology
Publication Date
July-December 2006


BACKGROUND: Change in diastolic function is one of the early hemodynamic manifestations in patients with myocardial ischemia.3 Elevated left atrial volume index (LAVI) has been shown to be strongly correlated with left ventricular dysfunction,M2 thus, by inference it can be an indicator of a myocardial ischemia during stress echocardiography. The primary objective of the study is to determine the LAVI response during the dobutamine stress echocardiography (DSE) of patients with or without myocardial ischemia, specifically by determining die diferrence between die baseline and peak LA volume indices during the procedure. METHODS: This prospective cross-sectional study enrolled forty-four (44) patients who underwent DSE at the Philippine Heart Center Non-invasive Laboratory from June 1,2005 to August 31,2005. Baseline 2-D echocardiography with Doppler study including diastolic function assessment was done on each patient. LA volume as determined by the biplane area-length method15 was taken both before and at die peak of the procedure. RESULT: There were 31 patients with normal wall motion (NWM) and 13 patients with abnormal wall motion (AWM). The mean peak LAVI in patients with AWM (28.83 +/- 10.02 cc/m2) is higher compared to the mean peak LAVI in patients with NWM (17.77 +/- 5.77 cc/m2), and the difference between two groups is statistically significant (p=0.000). There is a significant drop in LAVI from baseline to peak of dobutamine infusion in patients with NWM (-5.13 +/- 5.68;p=000). There is no significant change in LAVI from baseline to peak of dobutamine infusion in patients with AWM (+0.65 +/- 6.58;p=0.729). Their difference is statistically significant (p=0.005). Seven (7) of the thirteen (13) patients who had abnormal wall motion on DSE eventually underwent coronary angiography and all of diem were proven to have coronary artery disease. CONCLUSION: LAVI change during DSE therefore, could be an important indicator in the detection of CAD. (Author)

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