OBJECTIVE

To describe the protocol of diastolic stress test in patients with coronary artery disease, optimal time frame for assessing left ventricular diastolic function, and also to determine diagnostic accuracy of diastolic stress test in verification of coronary artery disease.

MATERIAL AND METHODS

There were 80 patients over 18 years old including 12 ones with previous myocardial infarction and decrease in left ventricular systolic function and 15 patients with baseline reduced left ventricular diastolic function. Mean age of patients was 56.0±12.2 years. Patients with absolute contraindications for stress-test were excluded. Analysis of anamnesis, physical examination, blood pressure measurement and electrocardiography at rest were followed by stress echocardiography with treadmill test. We assessed diastolic function in 10, 20, 40 and 60 seconds after exercise for 12 seconds. All patients underwent contrast-enhanced visualization of coronary arteries.

RESULTS

The highest diagnostic accuracy of LV diastolic function parameters (comparison of diastolic function before and after exercise) in detecting a significant coronary lesion was detected in 10—20 seconds after exercise: sensitivity 81.2% (95% CI 65.1—92.5), specificity 89.3% (95% CI 82.0—97.7), positive predictive value 90.2% (95% CI 80.0—95.2), negative predictive value 84.6% (95% CI 77.2—93.2). Diagnostic accuracy was 86.9% (95% CI 80.2—94.2).

CONCLUSION

It is optimal to assess LV diastolic function within 40 seconds after exercise. You should get the necessary images within 10—15 seconds. Analysis of diastolic function parameters after 40—60 seconds reduces sensitivity and specificity of diastolic stress test.