caa a22 4500 475791436 CHVBK 20180406123712.0 cr unu---uuuuu 170329e20001201xx s 000 0 eng 10.1023/A:1010631606609 doi (NATIONALLICENCE)springer-10.1023/A:1010631606609 The diagnostic value of Doppler echocardiographic indexes of diastolic filling for detecting demand ischemia in anesthetized patients [Elektronische Daten] [Manfred Seeberger, Miodrag Filipovic, Reinhard Rohlfs, Olivia Dergeloo, Wolfgang Studer, Dan Atar, Peter Buser, Karl Skarvan] In awake patients, Doppler indexes of transmitral flow velocities have been shown to be more sensitive for detection of myocardial ischemia than echocardiographic evaluation of systolic wall-motion. The diagnostic value of these indexes in anesthetized patients is unknown. It might differ from that in awake patients because anesthetics and sympathomimetic drugs, which are commonly used in surgical patients with coronary artery disease (CAD), independently affect transmitral flow velocities. Methods: Several previously published transmitral Doppler echocardiographic indicators of ischemia (marked decreases in the ratio of peak early [E] to peak atrial [A] filling velocity [E/A], in the ratio of early to atrial time-velocity integral [EI/AI], in E, in E acceleration, and in total diastolic time-velocity integral) were compared with standard wall-motion analysis and ST-segment analysis during dobutamine stress echocardiography (DSE) in 17 anesthetized patients with CAD and 7 age-matched control patients at low risk of CAD. Results: All patients with CAD but no control patients showed new systolic wall-motion abnormalities and/or ST-segment changes. Decreases of >10% in E/A and EI/AI were found in 88% and 71% of the patients with CAD and in 71% and 100% of the control patients, respectively. These decreases were found during dobutamine infusion at as low as 10 mcg/kg/min in several control patients. None of the other studied Doppler indexes were found useful to detect ischemia. Conclusions: Doppler echocardiography of diastolic transmitral flow velocities is of no appreciable diagnostic value for detecting ischemia in anesthetized patients who receive dobutamine at 10-40 mcg/kg/min. Kluwer Academic Publishers, 2000 diastolic filling nationallicence dobutamine nationallicence Doppler echocardiography nationallicence general anesthesia nationallicence myocardial ischemia nationallicence Seeberger Manfred Department of Anesthesia, Division of Cardiology, University of Basel, Basel, Switzerland aut Filipovic Miodrag Department of Anesthesia, Division of Cardiology, University of Basel, Basel, Switzerland aut Rohlfs Reinhard Department of Anesthesia, Division of Cardiology, University of Basel, Basel, Switzerland aut Dergeloo Olivia Department of Anesthesia, Division of Cardiology, University of Basel, Basel, Switzerland aut Studer Wolfgang Department of Anesthesia, Division of Cardiology, University of Basel, Basel, Switzerland aut Atar Dan Department of Internal Medicine, Division of Cardiology, University of Basel, Basel, Switzerland aut Buser Peter Department of Internal Medicine, Division of Cardiology, University of Basel, Basel, Switzerland aut Skarvan Karl Department of Anesthesia, Division of Cardiology, University of Basel, Basel, Switzerland aut The International Journal of Cardiac Imaging Kluwer Academic Publishers 16/6(2000-12-01), 437-446 0167-9899 16:6<437 2000 16 10554 https://doi.org/10.1023/A:1010631606609 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1023/A:1010631606609 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Seeberger Manfred Department of Anesthesia, Division of Cardiology, University of Basel, Basel, Switzerland aut NATIONALLICENCE 700 1- Filipovic Miodrag Department of Anesthesia, Division of Cardiology, University of Basel, Basel, Switzerland aut NATIONALLICENCE 700 1- Rohlfs Reinhard Department of Anesthesia, Division of Cardiology, University of Basel, Basel, Switzerland aut NATIONALLICENCE 700 1- Dergeloo Olivia Department of Anesthesia, Division of Cardiology, University of Basel, Basel, Switzerland aut NATIONALLICENCE 700 1- Studer Wolfgang Department of Anesthesia, Division of Cardiology, University of Basel, Basel, Switzerland aut NATIONALLICENCE 700 1- Atar Dan Department of Internal Medicine, Division of Cardiology, University of Basel, Basel, Switzerland aut NATIONALLICENCE 700 1- Buser Peter Department of Internal Medicine, Division of Cardiology, University of Basel, Basel, Switzerland aut NATIONALLICENCE 700 1- Skarvan Karl Department of Anesthesia, Division of Cardiology, University of Basel, Basel, Switzerland aut NATIONALLICENCE 773 0- The International Journal of Cardiac Imaging Kluwer Academic Publishers 16/6(2000-12-01), 437-446 0167-9899 16:6<437 2000 16 10554 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer