Abstract 18617: Comparative Evaluation of the Diagnostic Accuracy of Dobutamine Stress Echocardiography Strain Imaging to Detect Ischaemia as Assessed by Fractional Flow Reserve and the Instantaneous Wave-free Ratio

Introduction: Dobutamine stress echocardiography (DSE) is widely used in clinical practice although it remains subjective. Strain imaging by speckle-tracking echocardiography provides an automated and objective method of detecting inducible ischaemia by DSE. However its accuracy has never been evaluated against a true gold standard. In this study we aim to determine the diagnostic performance of strain imaging for the detection of ischaemia in coronary artery disease (CAD). Methods: Consecutive patients undergoing DSE were assessed using strain analysis and expert visual assessment. Regional and global peak-systolic longitudinal strain were recorded at baseline and peak stress and displayed as a Bull’s-Eye graphic. All patients had invasive measurement of fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR) to assess ischaemia. Clinicians were blinded to patient information and investigation results. Results: We analysed 128 patients (mean age 68±9 years, 96 (75%) men) with stable angina ...