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Cardiac Stress Test Induced by Dobutamine and Monitored by Cardiac Catheterization in Mice
Published on: February 10, 2013
Usefulness and limitations of dobutamine-atropine stress echocardiography for the diagnosis of coronary artery
M L Geleijnse1, C Vigna, J D Kasprzak
1Thoraxcentre, University Hospital Rotterdam-Dijkzigt and Erasmus University, Rotterdam, The Netherlands.
European Heart Journal
|October 18, 2000
Summary
Dobutamine-atropine stress echocardiography shows high accuracy for coronary artery disease in left bundle branch block patients. However, abnormal resting septal thickening may reduce sensitivity for anterior circulation disease detection.
Area of Science:
- Cardiology
- Diagnostic Imaging
- Echocardiography
Background:
- Left bundle branch block (LBBB) can impair stress echocardiogram interpretation due to abnormal septal motion.
- Assessing diagnostic value of dobutamine-atropine stress echocardiography (DASE) in LBBB patients is crucial.
Purpose of the Study:
- To evaluate the diagnostic utility of DASE in LBBB patients with suspected coronary artery disease (CAD).
- To determine if resting ECG characteristics can predict DASE effectiveness.
Main Methods:
- 64 LBBB patients with suspected CAD underwent DASE and coronary arteriography.
- Myocardial ischemia defined by new/worsening wall thickening abnormalities.
- CAD defined as >/=50% diameter stenosis in a major epicardial artery.
Main Results:
- DASE demonstrated high specificity (94% anterior, 98% posterior circulation).
- Overall accuracy was 86% for anterior and 92% for posterior circulation.
- Sensitivity for anterior circulation was lower (60%) and further reduced in patients with abnormal rest septal thickening (44% vs 83%).
Conclusions:
- DASE is highly specific for CAD in LBBB patients.
- Abnormal rest septal thickening may limit DASE sensitivity for anterior CAD.
- Resting ECG may help select LBBB patients who benefit most from DASE.
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