Is quantitative interpretation likely to increase sensitivity of dobutamine stress echocardiography? A study of false-negative results

Background: False-negative interpretations of do-butamine stress echocardiography (DSE) may be associated with reduced wall stress. using measurements of contraction, we sought whether these segments were actually ischemic but unrecognized or showed normal contraction. Methods. We studied 48 patients (29 men; mean age 60 +/- 10 years) with normal regional function on the basis of standard qualitative interpretation of DSE. At coronary angiography within. 6 months of DSE, 32 were identified as having true-negative and 16 as having false-negative results of DSE. Three apical views were used to measure regional function with color Doppler tissue, integrated backscatter, and strain rate imaging. Cyclic variation of integrated backscatter was measured in 16 segments, and strain rate and peak systolic strain was calculated in 6 walls at rest and peak stress. Results. Segments with false-negative results of DSE were divided into 2 groups with and without low wall stress according to previously published cut-off values. Age, sex, left ventricular mass, left ventricular geometric pattern, and peak workload were not significantly different between patients with true and false-negative results of DSE. Importantly, no significant differences in cyclic variation and strain parameters at rest and peak stress were found among segments with true-and false-negative results of DSE with and without low wall stress. Stenosis severity had no influence on cyclic variation and strain parameters at peak stress. Conclusions: False-negative results of DSE reflect lack of ischemia rather than underinterpretation of regional left ventricular function. Quantitative markers are unlikely to increase the sensitivity of DSE.

Three-component force measurements on a large scramjet in a shock tunnel

A stress-wave force balance for measurement of thrust, lift, and pitching moment on a large scramjet model (40 kg in mass, 1.165 in in length) in a reflected shock tunnel has been designed, calibrated, and tested. Transient finite element analysis was used to model the performance of the balance. This modeling indicates that good decoupling of signals and low sensitivity of the balance to the distribution of. the load can be achieved with a three-bar balance. The balance was constructed and calibrated by applying a series of point loads to the model. A good comparison between finite element analysis and experimental results was obtained with finite element analysis aiding in the interpretation of some experimental results. Force measurements were made in a shock tunnel both with and without fuel injection, and measurements were compared with predictions using simple models of the scramjet and combustion. Results indicate that the balance is capable of resolving lift, thrust, and pitching moments with and without combustion. However vibrations associated with tunnel operation interfered with the signals indicating the importance of vibration isolation for accurate measurements.