The additive value of three-dimensional derived left atrial volume and carotid imaging in dobutamine stress echocardiography

Abstract

Aims: To evaluate whether the three-dimensional (3D) left atrial volume index (LAVI) and/or the presence of carotid plaques (CP) can predict the result of dobutamine stress echocardiography (DSE), thereby aiding interpretation. Methods and resultsWe studied 130 patients (52 male, mean age 63 ± 11 years) with normal resting wall motion (WM) undergoing DSE. All patients had the end-systolic 2D and 3D LAVI measured, as well as bilateral carotid scanning. DSE was reported as abnormal in 50 (38.5) patients. 3D end-systolic LAVI measurements were significantly higher (31.5 ± 8.2 vs 27.4 ± 7.4 mL/m2, P 0.004) in those with an abnormal DSE. The two groups did not differ significantly on the 2D derived maximum LAVI measurements (36.2 ± 9.5 vs 34.2 ± 11.2, P 0.299) and the presence of plaques in the carotid arteries (89.1 vs. 76.2, P 0.100). Receiver operating characteristic curves were created to define cut-offs that could predict the DSE result for the 3D LAVI. A 3D LAVI of >24.5 mL/m2 had a sensitivity of 80 for predicting an abnormal DSE, whereas a value of >36.0 mL/m2 had a specificity of 93 for the same cause. Intra-observer (r 0.997, P < 0.0001) and inter-observer (r 0.961, P < 0.0001) variability for 3D LAVI measurements was found to be excellent.ConclusionThree-dimensional (but not 2D) assessment of LAVI may offer additional information in predicting the result of DSE. Carotid scanning did not offer additional information for the same cause. © The Author 2010.