Monday, 1 September 2008 - European Heart Journal

280 Stress echo in clinical practice / Non-invasive testing for arrhythmias
chaemia. Therefore, we developed a three-dimensional (3D) analysis tool that
makes it possible to anatomically align 3D rest and stress data systematically,
to generate optimal, non-foreshortened standard anatomical cross sections and
to analyse the images synchronised and side-by-side. The aim of the present
study was to investigate whether this 3D analysis tool could improve interobserver
agreement on myocardial ischaemia during 3D DSE.
Methods: The study comprised 34 consecutive patients (22 men, mean age
57±13 years) with stable chest pain who underwent both non-contrast and contrast
3D DSE. Two observers scored segmental wall motion using a conventional
analysis and the novel analysis with the new 3D tool.
Results: At peak stress, 434 of the 578 segments (76%) could be analysed during
noncontrast 3D imaging. With contrast-enhanced 3D imaging, the number of
available left ventricular segments increased to 526 (91%). The two observers
agreed on the presence of myocardial ischemia in 81 of 102 coronary territories
(agreement 79%, kappa 0.28) during noncontrast 3D imaging and 92 of 102
coronary territories (agreement 90%, kappa 0.65) during contrast-enhanced 3D
imaging. With the new 3D analysis software these numbers improved to 98 of 102
coronary territories (agreement 96%, kappa 0.69) during noncontrast 3D imaging
and 98 of 102 coronary territories (agreement 96%, kappa 0.82) during contrastenhanced
3D imaging.
Conclusion: The use of a 3D DSE analysis tool improves interobserver agreement
for myocardial ischaemia both for non-contrast and contrast images.
NON-INVASIVE TESTING FOR ARRHYTHMIAS
1851 T-wave variability detects abnormalities in ventricular
repolarisation: a prospective study comparing healthy
persons and olympic athletes
L. Heinz1 ,A.Sax2 , F. Robert 2 , A. Urhausen2 , D. Luhm3 ,
R. Ocklenburg3 ,J.O.Schwab4 . 1Bonn, Germany; 2Luxembourg, Luxembourg; 3Muenchen, Germany; 4University of Bonn, Department of
Medicine-Cardiology, Bonn, Germany
Introduction: Sudden cardiac death in athletes is more common than in the general
population. Routine screening procedures are performed to identify competitors
at risk. A new, Holter based parameter, analyses variation of the ventricular
repolarization (TVAR). The aim of the present study was to evaluate differences in
ECG, Echo, and Holter (H) in competitive athletes compared to a healthy control
group consisting of medical students (MS).
Methods: 40 athletes (19 female, Olympic Team, Luxembourg) and 40 MS (22
female) were examined by means of a resting ECG, treadmill exercise (TE),
echocardiogram (Echo), as well as H recordingsduring a routine screening visit.
To analyze TVAR, a 20 min H recording at rest (sampling rate 2000 s -1 )was
performed.
Results: No differences in demographic variables were detected. The Table illustrate
the findings of echo and H computations.
Parameters of Echocardiography/Holter
Parameter Athletes (mean±SD) Students (mean±SD) P-value
Heart rate (bpm) 66±8 77±7