[Stress echocardiography: analysis of results in 100 coronary angiography patients]

Stress echocardiography is increasingly accepted as a reliable, noninvasive method for assessment of coronary artery disease. We retrospectively analysed the results of the first 100 consecutive patients (79 males, 62 +/- 10 years), who had both stress echocardiography and coronary angiography within 3 months without intercurrent revascularisation. In 71% of the patients treadmill- was performed and in 29% dobutamine-stress echocardiography. No patient had severe side effects. In the 100 patients, positive predictive accuracy for detection of significant coronary artery disease was 95% and for multivessel disease 80%. There was no significant difference in positive predictive value for detection of significant stenosis in the posterior perfusion territory (left circumflex, right coronary artery), with 79% compared to the anterior perfusion territory (86%, p = ns). Sensitivity for the left circumflex (60%) tended to be lower compared to the right coronary artery (76%) or left anterior descending coronary artery (82%) (p = ns). Despite poorer echocardiographic image quality in dobutamine-stress echocardiography patients, there was no significant difference between treadmill- and dobutamine-stress echocardiography regarding the positive predictive value for detection of coronary artery disease (98 vs 92%) or for recognition of multivessel disease (79 vs 79%) (p = ns). False results of stress echocardiography were rare (7%): false positive results were more common in the presence of wall motion abnormalities at rest, false negative results after an insufficient stress-induced increase in heart rate. Gender or left ventricular hypertrophy had no impact on stress echocardiography results (p = ns). In conclusion, both dobutamine- and treadmill-stress echocardiography are reliable, sensitive methods for non-invasive assessment of coronary artery disease; this is also valid in women and in left ventricular hypertrophy.