Does second harmonic imaging improve left ventricular endocardial border identification at higher heart rates during dobutamine stress echocardiography?
GROUND: The increased heart rate during dobutamine stress echocardiography (DSE) may impair endocardial border visualization. Second harmonic imaging (SHI) enhances left ventricular (LV) border visualization compared with conventional fundamental imaging (FI) at rest. However, its role during DSE is not well established yet. OBJECTIVE: Our objective was to compare the additional value of SHI to FI for the LV endocardial border visualization during various stages of DSE. METHODS: Eighty patients underwent DSE. Imaging was performed with both FI and SHI at rest and at low-and peak-dose dobutamine infusion. Endocardial border visualization was assessed by using a 16-segment/3-point score (0 = well visualized; 1 = poorly visualized; 2 = not visualized). RESULTS: Heart rate increased from rest (70 +/- 13 bpm) to low-dose dobutamine (77 +/- 17, P <.01) and showed further increase at peak dose (129 +/- 16, P <.001 versus low dose). There was a higher prevalence of segments with an invisible L
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