Efficacy of Ultrasound-assisted Stress Testing Using a Hand-carried Ultrasound Device for Diagnosis of Coronary Artery Disease

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Abstract

Background

Exercise echocardiography is an effective means of noninvasively detecting coronary artery disease (CAD), and hand-carried cardiac ultrasound (HCU) devices are now being used to diagnose CAD in emergency rooms and at bedsides.

Objective

To compare the efficacies of exercise echocardiography with an HCU device (EchoCG-HCU) and exercise electrocardiography (ECG) in the diagnosis of CAD.

Methods

Fifty-eight patients underwent symptom-limited treadmill exercise testing. Two-dimensional echocardiographic images were obtained from standard parasternal and apical windows at rest and immediately after exercise using an HCU device (180 PLUS SonoSite Inc, Bothell, Wash). Wall motion was scored for each of 16 left ventricular segments using a 5-point grading system. The development of new or worsening wall motion was considered to be indicative of ischemia.

Results

When identifying CAD using exercise ECG, the sensitivity ws 63%, the specificity was 72%, and the diagnostic accuracy was 69%. By comparison, with exercise EchoCG-HCU the sensitivity was 68%, the specificity was 90%, and the diagnostic accuracy was 83%. Moreover, the specificity of exercise EchoCG-HCU was significantly higher than that of exercise ECG (p < .05).

Conclusion

Exercise EchoCG-HCU is at least as useful as exercise ECG for diagnosing CAD.

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