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S44 Abstracts Heart, Lung and Circulation2008;17S:S1–S209

relations between CTCA and stress echo in patients withchest pain and intermediate pre-test probability.Methods: Forty-two patients (aged 55 ± 12 years, 26 men)with chest pain and high prevalence of coronary riskfactors (19% smokers, 17% diabetes, 67% hypercholestero-laemia, 57% hypertension) underwent 64-slice CTCA andstress echo after exclusion of acute coronary syndrome.Results: Six patients had inducible ischaemia on stressecho whereas eight patients had significant disease(>50% luminal stenosis) on CTCA. Patients with inducibleischaemia on stress echo had a significantly higher totalAgaston calcium score compared with those without (349.5vs. 128.1, p = 0.04). There was a significant but mod-est agreement between CTCA findings of >50% luminalstenosis and inducible ischaemia on stress echo (concor-

Tissue-velocity mapping (TVM) allows rapid, easy mea-surement of mitral valve annular displacement (MVAD).MVAD measures longitudinal annular descent with ref-erence to a single point. We sought to optimise this newtechnique by comparing TVM measurements with two dif-ferent reference points (apical epicardium and origin ofthe sector).Methods: Forty-three normal subjects (21 men, mean age37 years (range 26–45)) underwent standard echocardio-graphy (Philips iE33) and images were analysed usingQ-Lab software (Philips). Simpson’s biplane LV volumesand EF were measured. MVAD was assessed by placingpoints on the lateral and medial mitral annuli and a refer-ence point placed at (1) epicardial apex, and (2) origin ofthe sector. Average MVAD and %MVAD were comparedbetween methods, and with EF and tissue Doppler systolicvelocity.

dance 86%, p = 0.001, kappa 0.49) with the best agreementbeing in the right coronary artery (RCA) distribution (con-cordance 98%, p < 0.001, kappa 0.84). Of the eight patientswith luminal narrowing of >50% on CTCA, only four (50%)had inducible ischaemia on stress echo.Conclusions: In patients with chest pain and intermedi-ate pre-test probability, (1) there was a significant butmodest agreement between CTCA and stress echo; (2) theagreement between anatomic data with CTCA and func-tional data with stress echo was best in RCA territory; (3)patients with inducible ischaemia on stress echo had sig-nificantly higher total Agaston calcium score; (4) CTCAshowed luminal stenosis in a significant proportion with-out ischaemia on stress echo.

doi:10.1016/j.hlc.2008.05.102

102Initial Experience with Automated Echocardiographic Tis-sue Tracking of the Mitral Annulus in Normal Subjects

Adele Pope ∗, Katrina Poppe, Helen Walsh, AndrewYeadon, Georgina Dew, Rob Doughty, Gillian Whalley

University of Auckland, Auckland, New Zealand

Longitudinal left ventricular (LV) function is an impor-tant contributor to the overall systolic LV function butdifferentiating long axis function by echo is difficult.

Results: MVAD at each reference point was closely corre-lated (r = 0.98), and although %MVAD correlated (r = 0.89),bias was observed (see Figure). The mean %MVAD was2.9 ± 2.1 (sector) versus 14.7 ±1.9 (epicardium) (p < 0.0001)while the mean MVAD was 14.1 ± 1.9 (sector) versus14.1 ± 2.1 (epicardium) (p = 0.60). Moderate correlation wasseen with pulsed wave tissue Doppler velocities (r = 0.65)but neither MVAD nor %MVAD were correlated with EFin our cohort.Conclusions: MVAD is reliably assessed by TVM irre-spective of the reference point, but when presented asa percentage of long axis length, different results areobtained, indicating care is needed in application of thistechnique. Its relevance in normal subjects is uncertain.

doi:10.1016/j.hlc.2008.05.103