Diagnostic Test Squatting Stress Echocardiography and Coronary Angiography in Diagnosing Coronary Heart Disease
Abstract
Background: In patients with significant coronary heart disease (CHD), increased preload and afterload during a squat can cause wall motion abnormalities (WMA) which can be detected on echocardiography. This study was conducted to determine the diagnostic value of stress echocardiography squatting as a non-invasive examination of a relatively simple, inexpensive, and safe in the detection of coronary artery stenosis in stable CHD and unstable angina patients.
Methods: This study was a cross-sectional design. The subjects were all patients with stable CHD and unstable angina whom were treated in Instalasi Pusat Jantung Rumah Sakit Dr. M. Djamil Padang from May to July 2016. Subjects underwent squatting stress echocardiography procedures followed by coronary angiography. Diagnostic test was used to determine the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of squatting stress echocardiography.
Results: The sensitivity, specificity, and accuracy of squatting echocardiography for diagnosis of CAD were 90.3%, 88.9% and 89.7%, respectively.
Conclusion: Squatting stress echocardiography can be proposed as a non-invasive examination which is relatively simple, inexpensive and safe to detect coronary artery stenosis on patients with stable CHD and unstable CHD.
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References
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2. Mozaffarian D, Benjamin EJ, Go AS, et al. AHA statistical update. Heart disease and stroke statistics 2015. Update a report from the American Heart Association. Circulation. 2015;131:e1-e294.
3. Trihono. Riset kesehatan dasar. Badan Penelitian dan Pengembangan Kesehatan Kementerian Kesehatan RI. 2013.
4. Almasdy D, Darwin D, Kurniasih N, Handayani V. Pola penggunaan isdn pada penderita angina pektoris di suatu rumah sakit pemerintah kota Padang. Jurnal Sains dan Teknologi Farmasi. 2013;18:61-8.
5. Chandraratna PAN, Kuznetsov VA, Mohar DS, et al. Comparison of squatting stress echocardiography and dobutamine stress echocardiography for the diagnosis of coronary artery disease. Echocardiography. 2012;29:695-9.
6. Fihn SD, Gardin JM, Abrams J, et al. Guideline for the diagnosis and management of patients with stable ischemic heart disease. A report of the American College of Cardiology Foundation/American Heart Association task force on practice guidelines, and the American College of Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Circulation. 2012;126:e354-e471.
7. Roffi M, Patrono C, Collet JP, et al. 2015 esc guidelines for the management of acute coronary syndromes in patients presenting without persistent st-segment elevation. Task force for the management of acute coronary syndromes in patients presenting without persistent st-segment elevation of the European Society of Cardiology (esc ). European Heart Journal. 2015:1-59.
8. Murakami T. Squatting: The hemodynamic change is induced by enhanced aortic wave reflection. American Journal Of Hypertension. 2002;15:986–8.
9. Hanson P, Slane PR, Rueckert PA, Clark SV. Squatting revisited: Comparison of haemodynamic responses in normal individuals and heart transplantation recipients. 1995;74:154–8.Jurnal Kardiologi Indonesia 198 Jurnal Kardiologi Indonesia • Vol. 37, No. 4 • Oktober - Desember 2016.
10. Scheen AJ, Philips J-C. Squatting test: A dynamic postural manoeuvre to study baroreflex sensitivity. Clinical Autonomic Research Society. 2011:1-9.
11. Tutaj M, Marthol H, Berlin D, Brown CM, Axelrod FB, Hilz MJ. Effect of physical countermaneuvers on orthostatic hypotension in familial dysautonomia. Journal of Neurology. 2006;253:65-72.
12. Salazar SA, Borrero JL, Harris DM. On systolic murmurs and cardiovascular physiological maneuvers. American Physiological Society. 2012;36:251–6.
13. Montalescot G, Sechtem U, Achenbach S, et al. Esc guidelines on the management of stable coronary artery disease. The task force on the management of stable coronary artery disease of the european society of cardiology. European Heart Journal. 2013;34:2949–3003.
14. Amsterdam EA, Wenger NK, Brindis RG, et al. 2014 AHA/ACC guideline for the management of patients with non–st-elevation acute coronary syndromes. A report of the American College of Cardiology/American Heart Association task force on practice guidelines. Developed in collaboration with the Society for Cardiovascular Angiography and Interventions and Society of Thoracic Surgeons endorsed by the American Association for Clinical Chemistry. Circulation. 2014;130:e344-e426.
15. Rosendorff C, Lackland DT, Allison M, et al. Treatment of hypertension in patients with coronary artery disease. A scientific statement from the American Heart Association, American College of Cardiology, and American Society of Hypertension. Journal of the American College of Cardiology. 2015;65:1998-2038.
16. Ridker PM, Libby P, Buring JE. Risk markers and the primary prevention of cardiovascular disease. In: Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald’s heart disease. A textbook of cardiovascular medicine, 10th edition. Philadelphia: Elsevier Inc; 2015:1029-56.
17. Depre C, Gross GJ, Vatner SF. Coronary blood flow and myocardial ischemia. In: Fuster V, Walsh RA, Harrington RA, eds. Hurst’s the heart. United States The McGraw-Hill Companies, Inc; 2011:1968-90.
18. Giugliano RP, Cannon CP, Braunwald E. Non–ST elevation acute coronary syndromes. In: Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald’s heart disease. A textbook of cardiovascular medicine, 10th edition. Philadelphia: Elsevier Inc; 2015:1155-77.
19. Canty JM, Duncker DJ. Coronary blood flow and myocardial ischemia. In: Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald’s heart disease. A textbook of cardiovascular medicine, 10th edition. Philadelphia: Elsevier Inc; 2015:1029-56.
20. Braunwald E. Unstable angina and non–ST elevation myocardial infarction. American Journal of Respiratory and Critical Care Medicine. 2012;185:924–32.
21. Pellikka PA, Nagueh SF, Elhendy AA, et al. American Society of Echocardiography recommendations for performance, interpretation, and application of stress echocardiography. Journal of the American Society of Echocardiography. 2007;20:1021-41.
Published
2017-04-18
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How to Cite
Rahman, A., Yanni, M., & Syafri, M. (2017). Diagnostic Test Squatting Stress Echocardiography and Coronary Angiography in Diagnosing Coronary Heart Disease. Indonesian Journal of Cardiology, 37(4), 190-8. https://doi.org/10.30701/ijc.v37i4.583
Section
Clinical Research
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