The Exploration Of The Diagnostic Value Of Stress Echocardiography With Transesophageal Atrial Pacing In Patients With Coronary Artery Disease

Background: There are few study on the feasibility and accuracy of stress Echocardiography with transesophageal atrial pacing. The objective of this study is to evaluated the diagnostic value of stress echocardiography with transesophageal atrial pacing in patients with coronary artery disease. Methods: stress echocardiography with transesophageal atrial pacing was performed in 80 Patients who have chest pain jand suspected coronary artery disease before coronary arteriographywithin one week. 4 patients can not complete the test for different j reasons. 76 of 80 Patients accepted the test. Of the 76 patients who underwent coronary arteriography, 24 patients had 1-vessel disease (stenosis changes≥50%). and were defined as single-vessel group. 30 patient had 2-vessel or more vessel disease and were defined as multiple- j vessel group. 22 patients who had no significant disease (stenosis j changes <50%) were defined as normol group. Then,wall motion abnormalit or a worsening of preexisting abnormalities were recorded at rest and peak rate in stress echocardiography with transesophageal atrial pacing. Results: 1)76 of the 80 patients underwent transesophageal atrial pacing (95%). 69 of the 76 patients (91%) achieved target heart rate of >85% of the age-predicted heart rate (220-age). It is well tolerated, more easily accepted. 2)stress Echocardiography with transesophageal atrial pacing and coronary arteriography correlated well for identification or exclusion of coronary artery disease in 64 of 76 patients (84.2%, k o.65, p<0.05). 3)The specificity of the technigue was 91% and the sensitivity for single or multiple vessel diseas was 75%,87%, respectively. 4)From this test, it could be easier to distinguish anlerior wall than other left ventricular wall and most sensitive to the left anterior decending artery among coronary arterys; the detected sensitivity of proximal segment of main coronary including branches is higher than the distal ones. Conclution: We found stress echocardio-graphy with transesophageal atrial pacing to be feasible and safe. It is quick to perform and valuable for the detection of inducible myocardial ischemia as well as for identifying the location and extent of inducible myocardial ischemia including both single-vessel and multiple- vessel group. The more increase of the vessel diseases, the better of the accuracy diagnosis of the coronary artery disease.Thus, it is one of the ways for coronary artery disease diagnosis.