Dobutamine Stress Echocardiography for Detecting Coronary Artery Disease

Abstract

To assess the value of dobutamine stress echocardiography (DSE) to detect coronary artery disease (CAD) and to compare the diagnostic accuracy between DSE and treadmill exercise test (TXT), 104 patients (mean age 58 ± 12 years) presenting for coronary angiography were prospectively studied. TXT was performed according to the Bruce protocol. Dobutamine (5-40 µg/ kg/min) was infused in 3-min stages. Digital echocardiograms were recorded on-line at baseline, during low- and peak-dose dobutamine infusion, and at recovery. An echocardiogram positive for CAD was defined as the one showing a new wall motion abnormality (WMA) induced by dobutamine. There were no major complications during the study. Significant CAD (≧ 50% diameter stenosis) was present in 17 of 30 patients who had normal echocardiograms at baseline. The sensitivity for detecting CAD was 76% by TXT and 94% by DSE, and the specificity was only 38% by TXT and 92% by DSE, respectively. Seventy-four patients had localized rest WMAs. Twenty-four had no significant CAD or lesions only confined to regions with abnormal rest wall motion, and 50 had disease remote from these regions. The sensitivity for detection of remote disease was 60% by TXT and 76% by DSE, and the specificity was 75% by TXT and 96% by DSE, respectively. In conclusion, DSE is a safe and accurate diagnostic tool for identifying CAD and for predicting the extent of disease in those who have localized rest WMAs.

Dobutamine stress echo has marginal utility and is context-dependent for assessing myocardial ischemia

“…[1][2][3][4][5][6][7][8][9][10][11][12][13] Newer tests using augmentation techniques, alternative imaging or myocardial stress procedures were developed after that time and supplanted dobutamine stress echocardiography as the test of choice. [1][2][3][4][5][6][7][8][9][10]14 This analysis looked at papers reporting a gold standard of coronary angiography, in which the intent was to diagnose coronary artery disease in a moderate risk population. There was a fairly even mix of positive angiograms with results between 50% versus 70% stenosis.…”

“…Multiple small papers (six of twelve, N < 100), including the one reviewed, used case series or cross-sectional designs. [1][2][3][4][5][6][7][8][9][10] All papers suffered from inclusion bias, since only patients who were candidates for both tests were included in the analysis. No paper featured a prospective study design specifically to determine test characteristics; rather, all of the available evidence came from patient care experiences.…”

Assessment of ischemia by using dobutamine stress echocardiography test in patients with isolated ST depression in inferior leads demonstrated during channel treadmill exercise electrocardiography test

“…21 Wu ve arkadaş-ları ise duyarlılığı %76, özgüllüğü %38 buldular. 22 Hennessy ve arkadaşları TMET ve DSET karşılaştır-masında DSET duyarlılığını (%82), TMET duyarlılı-ğından (%40) daha yüksek bulmuşlardır. 23 Chikamori ve arkadaşları egzersiz EKG'nin KAH tanısında doğruluk değerini belirlemek amacıyla yaptıkları çalışmada, izole inferior ((Dıı,Dııı ve aVF)) ve inferior derivasyonlar ile birlikte lateral (V4 -V5 -V6) derivasyonlarda ST segment depresyonu olan olguları karşılaştırmışlardır.…”

Current Approaches to Evaluation of the Multivessel Coronary Atherosclerosis in Patients With Chronic Ischemic Heart Disease

“…В случае невоз-можности выполнять физическую нагрузку пациенту про-водилась стресс-ЭХОКГ с добутамином. Стресс-ЭХОКГ Стресс-ЭХОКГ в оценке коронарного русла при ИБС с добутамином проводилась по следующему протоко-лу: после регистрации ЭКГ и ЭХОКГ в покое больному проводилась инфузия добутамина в возрастающих дозах 5-7,5-10-20-30-40 мкг/кг/мин с длительностью каждого этапа 3 мин [4]. ЭКГ и ЭХОКГ мониторинг про-водился постоянно в ходе всей продолжительности ис-следования.…”