Advantages of exercise echocardiography in comparison to dobutamine echocardiography in the diagnosis of coronary artery disease in hypertensive subjects

Abstract

Objective: The aim of the study was to compare the efficacy and safety of two stress echocardiography methods, exercise and dobutamine, in the diagnosis of coronary artery disease in hypertensive patients with angina. Patients and methods: A total of 197 treated hypertensive patients, age 53 ؎ 9 years (65 women) with no history of myocardial infarction referred for coronary angiography were prospectively investigated with exercise electrocardiography (ECG), exercise and dobutamine echocardiography. Results: Sensitivity of the exercise ECG, exercise echocardiography and dobutamine echocardiography did not differ (77%, 82% and 75%). Negative predictive value of exercise ECG was significantly lower than exercise echocardiography (64% vs 79%, P Ͻ 0.01). Specificity and positive predictive value of exercise ECG were markedly lower than exercise and dobutamine echocar-

Diagnostic value of electrocardiogram stress testing in patients with metabolic syndrome

“…First, the accuracy of ECG stress test, when it is based only on the ST-segment changes, is known to be limited [18]. Moreover, ECG stress test is associated with high rate of false-positive results, as mentioned below [7,15]. In addition, ECG exercise testing is more often false-positive in women compared to men because of the lower presence of CVD in women population [21].…”

“…Despite wellknown limitations of ECG stress testing, such as low sensitivity and specificity [5,6], high rate of false-positive results [7], this method is still widely used in screening and assisting the diagnosis of CHD [8,9]. ECG stress test is a non-invasive, inexpensive tool, which is also beneficial for stratifying prognosis in patients with suspected CHD [10].…”

Diagnosing cardiac disease in equine athletes: the role of stress testing

“…In man, cardiac stress testing is primarily performed to detect myocardial ischaemia secondary to coronary artery disease, although it has also been used to evaluate hypertrophic and dilated cardiomyopathies and valvular diseases (Robertson et al 1983;Berberich et al 1984;Marwick et al 1992;Beleslin et al 1994;Klues et al 1997;Pasierski et al 2001;Kosmala and Spring 2004;Tsutsui et al 2004;Wu et al 2004a,b). This technique has been studied extensively and is comparable to angiography.…”

“…This technique has been studied extensively and is comparable to angiography. It is more sensitive than exercising ECGs for detecting myocardial ischaemia (Marwick et al 1992;Beleslin et al 1994;Pasierski et al 2001). It is used routinely as a noninvasive means of assessing potential risk for ischaemic events.…”

“…In man, pharmacological stressors are also used, in place of exercise in those patients who either cannot or will not complete a sufficient exercise stress test (Beleslin et al 1994;Pasierski et al 2001;Kosmala and Spring 2004;Tsutsui et al 2004). As examined to date, they have a similar sensitivity, specificity and accuracy to exercise testing.…”