Methodology, feasibility, safety and diagnostic accuracy of dobutamine stress echocardiography

被引:351
|
作者
Geleijnse, ML
Fioretti, PM
Roelandt, JRTC
机构
[1] Thoraxcentre, Univ. Hosp. Rotterdam-Dijkzigt E., Rotterdam
关键词
D O I
10.1016/S0735-1097(97)00206-4
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Large numbers of patients referred for evaluation of chest pain are unable to perform adequate, diagnostic exercise testing. In these patients, dobutamine stress echocardiography (DSE) represents an alternative, exercise-independent stress modality. Apart from the similar to 5% of patients with an inadequate acoustic window, 10% of patients referred for this test have nondiagnostic (sub-maximal negative) test results. Serious side effects during or shortly after DSE are uncommon, with ventricular fibrillation or myocardial infarction occurring in similar to 1 of 2,000 studies. No deaths have been reported. On the basis of a total number of 2,246 patients, reported in 28 studies, the sensitivity, specificity and accuracy of the test for the detection of coronary artery disease (CAD) were 80%, 84% and 81%, respectively. Mean sensitivities for one-, two- and three-vessel disease were 74%, 86% and 92%, respectively. The sensitivity for detection of disease in the left circumflex coronary artery (55%) was lower, both compared with that for left anterior descending (72%) and right coronary artery disease (76%). The sensitivity of predicting multivessel disease by multiregion echocardiographic abnormalities varied widely, from 8% to 71%. In direct comparisons, DSE was superior to exercise electrocardiography and dipyridamole echocardiography and comparable to exercise echocardiography and radionuclide imaging,DSE is a useful, feasible and safe exercise-independent stress modality for assessing the presence, localization and extent of CAD. (C) 1997 by the American College of Cardiology.
引用
收藏
页码:595 / 606
页数:12
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