Evidence map›Paper›PMID 34277225›Full record

ArticleCureus2021

Tilting of the Cardiac Axis During Dobutamine Stress Echocardiography: Potential Marker for Ischemia.

Preetham Gunta, Angel López-Candales, Paramdeep Baweja, Michael Sweeney

Abstract readCase Reports
In one paragraph

Article in Cureus, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Preetham GuntaInternal Medicine, University of Missouri Kansas City, Kansas City, USA.
Angel López-CandalesCardiovascular Medicine, University of Missouri Kansas City, Kansas City, USA.
Paramdeep BawejaCardiovascular Medicine, University of Missouri Kansas City, Kansas City, USA.
Michael SweeneyCardiovascular Medicine, University of Missouri Kansas City, Kansas City, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Stress echocardiography is a tool for assessing the extent and severity of coronary artery disease (CAD) during physical or pharmacological stress. Transient worsening of regional left ventricular (LV) function during stress is a well-recognized abnormality of inducible ischemia. We present the case of a 57-year-old female with risk factors for CAD who was referred for a dobutamine stress echocardiogram for complaints of typical angina. It was interpreted as positive for inducible ischemia, but using unconventional criteria. Unfortunately, this study had reduced sensitivity due to LV hypertrophy. All LV wall segments were not clearly seen to comment on regional contractility, and an abnormal cardiac tilt from its axis was noted, suggestive of ischemia along the anteroseptal, anterior and lateral walls. Following this, a coronary angiogram showed diffuse CAD. The cardiac axis with the presence of a tilt as a potential measure of ischemia is previously unrecognized. The idea invokes a mathematical principle based on the direction and the magnitude of the vector of opposing walls during contractility. Simply implying that ischemic segments might contract in the same direction, vector magnitude will be less prominent; hence, "axial tilt" will occur. Prospective studies are needed to validate the feasibility and reproducibility of this abnormality in the assessment of ischemia and its viability in clinical practice.

Indexed as

cardiac axiscardiac axis tiltcardiac stress testischemic heart diseasetransthoracic echocardiogram

Identifiers

PMID34277225
PMCPMC8275067

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.