Echocardiographic detection of coronary artery disease during dobutamine infusion.

Sawada, Stephen; Segar, Douglas S.; Ryan, Thomas J.; Brown, Stephen E.; Dohan, Ali M.; Williams, Ronald N.; Fineberg, Naomi S.; Armstrong, William F.; Feigenbaum, Harvey

doi:10.1161/01.cir.83.5.1605

Cited by 644 publications

(219 citation statements)

References 27 publications

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“…16) When segments of the left ventricle were divided according to the territories supplied by each coronary artery, 9 segments that were supplied by the left anterior descending artery were assigned to the anterior infarct zone; basal and mid anterior septum (at parasternal long axis), mid septum, apical septum, apicolateral (at four chamber), inferoapical, anteroapical, and mid and basal anterior (at two chamber). 17) The wall motion score index (WMSI) was calculated under the basal condition and at the two dobutamine dose levels and defined as the sum of the individual wall motion scores divided by the respective number of the measured segments. 10) Inadequately visualized segments were not scored, and if more than 2 segments of the infarct zone or 4 or more of all 16 segments were not visualized, the study was considered inadequate for analysis.…”

Section: Methodsmentioning

confidence: 99%

The Relationship Between Terminal QRS Complex Distortion and Early Low Dose Dobutamine Stress Echocardiography in Acute Anterior Myocardial Infarction

et al. 2004

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SUMMARYAlthough the damage in myocardial infarction has been demonstrated to be related with the magnitude and number of ST elevation, its relation with terminal distortion of QRS is unclear. The relationship between terminal QRS distortion in ECGs on admission and the results of early low dose dobutamine stress echocardiography (LDSE) performed 6 ± 2 days later was investigated.Patients admitted to our clinic within the first six hours of their chest pain and without a prior infarction diagnosis were divided into two groups based on the admission electrocardiogram as the absence (QRS-, n = 33) or presence (QRS+, n = 29) of distortion of the terminal portion of the QRS in ≥ 2 leads (QRS+; J point at > 50% of the R wave amplitude in lateral leads or presence of ST elevation without S wave in leads V 1 -V 3 ).There were no significant differences between the groups with respect to thrombolytic therapy or reperfusion criteria. During LDSE, the infarct zone wall motion score index (WMSI) in the QRS-group was significantly decreased relative to baseline (from 2.93 ± 0.65 to 2.37 ± 0.84, P = 0.02), and it was significantly different compared with WMSI in the QRS+ group (P = 0.005). Improvement of akinetic regions to hypokinetic regions in the infarct zone (IZ) was found to be 33.5% (44/131) in the QRS-group and 17.8% (27/ 151 P = 0.004) in the QRS+ group. Furthermore, 55.1% (10/29) of the patients in the QRS+ group and only 18.1% (6/33) of those in the QRS-group did not respond to LDSE (P < 0.05). In multiple logistic regression analysis, while there was no relationship between good left ventricular functions (WMSI < 2) and terminal QRS distortion under basal conditions (P = 0.07), an independent relation was observed to exist between them after LDSE (P = 0.03, OR 4.48, 95% CI, 1.13-17.7). Moreover, plasma CK levels were higher in the QRS+ group (P = 0.03), whereas the ejection fraction was worse (P = 0.01). In both groups, there was no correlation between the Selvester score and left ventricle WMSI at baseline, but this correlation was significantly improved with LDSE (QRS-; r = 0.39 P = 0.02 and QRS+; r = 0.44 P = 0.01)From the

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Section: Methodsmentioning

confidence: 99%

The Relationship Between Terminal QRS Complex Distortion and Early Low Dose Dobutamine Stress Echocardiography in Acute Anterior Myocardial Infarction

et al. 2004

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“…It has been demonstrated to be a safe and useful method for detecting CAD. [11][12][13] However, results were obtained in studies in which patient populations were predominantly men, who have a higher prevalence of CAD than women; in addition, scant information is available in women. Studies have reported on heterogeneous populations since patients with previous myocardial infarction or known CAD had been included.…”

Section: Discussionmentioning

confidence: 99%

“…Dobutamine stress echocardiography (DOBE) is increasingly used for detection of CAD, 11,12 but its diagnostic accuracy has not been defined in women.…”

Section: Introductionmentioning

confidence: 99%

Dobutamine stress echocardiography in the diagnosis of coronary artery disease in women with chest pain: Comparison with different noninvasive tests

Rollán

Román

Vilacosta

et al. 2002

Clinical Cardiology

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SummaryBackground: Diagnosis of coronary artery disease (CAD) in women remains elusive. The classical diagnostic armamentarium has been found to be very limited. Dobutamine stress echocardiography has emerged as a powerful test in assessing CAD in the general population, but most studies failed to include women.Hypothesis: The accuracy of dobutamine stress echocardiography in the diagnosis of CAD in women with chest pain is high and superior to dipyridamole echocardiography, exercise electrocardiography, and sestamibi single-photon emission tomography (MIBI-SPECT) scintigraphy.Methods: We studied 99 consecutive women with chest pain and no previous history of CAD who underwent dobutamine echocardiography and coronary angiography. We also compared these results with those of dipyridamole echocardiography in 63 patients, exercise stress testing in 83 (48 conclusive), and MIBI-SPECT scintigraphy during dobutamine infusion in 54.Results: Significant CAD was found in 42 women. Sensitivity and specificity of dobutamine stress echocardiography were 69 and 89%, respectively. Dipyridamole echocardiogra-

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“…Dobutamine stress has now emerged as the best alternative to exercise with very similar diagnostic accuracy [17][18][19]. Dobutamine is a catecholamine with selective beta-1 adrenoreceptor agonist activity and a relatively weak action on alpha and beta-2 adrenoreceptors.…”

Section: Dobutamine Stress Echocardiographymentioning

confidence: 99%

Stress Echocardiography

Nihoyannopoulos¹

2008

J Echocardiogr

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Echocardiographic detection of coronary artery disease during dobutamine infusion.

Abstract: Echocardiography combined with dobutamine infusion is a safe and accurate method for detecting coronary artery disease and for predicting the extent of disease in those who have localized rest wall motion abnormalities.

Cited by 644 publications

References 27 publications

The Relationship Between Terminal QRS Complex Distortion and Early Low Dose Dobutamine Stress Echocardiography in Acute Anterior Myocardial Infarction

The Relationship Between Terminal QRS Complex Distortion and Early Low Dose Dobutamine Stress Echocardiography in Acute Anterior Myocardial Infarction

Dobutamine stress echocardiography in the diagnosis of coronary artery disease in women with chest pain: Comparison with different noninvasive tests

Stress Echocardiography

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