平野 豊, 山本 忠彦, 上原 久和, 小笹 義尚, 山田 覚, 井川 寛, 石川 欽司

Yutaka HIRANO, Tadahiko YAMAMOTO, Hisakazu UEHARA, Yoshinao OZASA, Satoru YAMADA, Hiroshi IKAWA, Kinji ISHIKAWA

近畿大学医学部第1内科学教室

First Department of Internal Medicine Kinki University School of Medicine. 377-2 Osakasayama-shi, Ono-higashi 589-8511, Japan

キーワード : Coronary artery disease , Exercise, Stress echocardiography

Peak-and post-exercise stress echocardiography were compared with respect to ability to detect coronary artery disease in 138 consecutive patients undergoing supine bicycle stress echocardiography. Sixty of these patients had single-vessel disease; 37, double-vessel disease; and 19, triple-vessel disease. Exercise was performed in the 20- to 30-degree left decubitus position on an echo-bed with an ergometer. Exercise started at 50 watts and was increased every 3 minutes in 25-watt increments to a maximum of 150 watts. Two-dimensional echocardiographic images were digitized and assigned in a quad-screen format for nonbiased interpretation. Total wall motion score (TWMS) was the sum of the wall motion score, from normokinesis (0) to dyskinesis (4), of 16 segments. Image quality score index (IQSI) was the mean of the image quality scores in all views. All of the patients underwent coronary arteriography. Significant coronary stenosis was denned as ≥75% stenosis of the large coronary arteries. Two-dimensional echocardiographic studies were adequate for analysis in 133 patients during the peak-exercise stage (peak-exercise) and in 137 patients 30 to 60 seconds after the end of exercise (post-exercise). TWMS at peak-exercise was higher than at post-exercise, while IQSI at peak-exercise was lower than at post-exercise. Sensitivity at peak-exercise versus that at post-exercise was 91% versus 79% (p