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英文誌(2004-)

Journal of Medical Ultrasonics

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1993 - Vol.20

Vol.20 No.07

Original Article(原著)

(0429 - 0435)

経食道心房ペーシング負荷心エコー図法による心筋虚血の診断

Stress Echocardiography with Transesophageal Atrial Pacing for Detection of Coronary Artery Disease

宝田 明1, 嶋谷 祐二1, 佐々木 正太1, 銕 寛之1, 林 孝俊1, 森田 哲夫2, 都留 正人2, 中島 義明2, 吉田 浩1

Akira TAKARADA1, Yuhji SHIMATANI1, Shouta SASAKI1, Hiroyuki KUROGANE1, Takatoshi HAYASHI1, Tetsuo MORITA2, Masato TSURU2, Yoshiaki NAKAJIMA2, Yutaka YOSHIDA1

1兵庫県立姫路循環器病センター循環器科, 2兵庫県立姫路循環器病センター放射線科

1Department of Cardiology, Himeji Cardiovascular Center, 2Department of Radiology, Himeji Cardiovascular Center

キーワード : Stress echocardiography, Transesophageal atrial pacing, Coronary artery disease

A two-dimensional echocardiography was performed at rest and during rapid transesophageal atrial pacing in 36 patients undergoing coronary arteriography to evaluate chest pain (chest pain syndrome: 6 cases; vasospastic angina: 6 cases; effort angina: 24 cases). Transesophageal atrial pacing was performed with 30 to 50msec pulses of 6 to 16 V and 10 to 15 mA intensity; heart rate was progressively increased up to 150 beats/min. Transesophageal atrial pacing was performed successfully in 32 of 36 patients (89%). The sensitivity and specificity of the technique for detecting coronary artery disease (defined as a luminal diameter narrowing of at least 75% in one or more major vessels) were 88% and 88%, compared with 92% and 75% for thallium 201 myocardial scintigraphy with bicycle exercise. The sensitivity of transesophageal atrial pacing echocardiography for one, two or three vessel disease was 94%, 80%, and 100%, respectively. Ischemia-induced wall motion abnormalities were detected earlier than observed electrocardiographic changes and symptoms. Thus, two-dimensional echocardiography during transesophageal atrial pacing is a highly specific and sensitive technique for the detection of coronary artery disease.