[Echocardiography under perfusion with dobutamine. Experience of Tunisian cardiologic service. About 70 cases]

We report a prospective study which began on February 1st, 1999. 70 consecutive and non selected patients got dobutamine stress echocardiography. The major indication, in 53% of cases, was detection of coronary disease in patients suffering from chest pain but whose stress testing were not conclusive. Dobutamine was continuously and intravenously administered at doses ranging from 5 to 40 microg. Maximal dose was obtained in 73% of cases. The most frequent reason that led us to stop the test was the reach of the target cardiac frequency (85 of FMT). We observed 7 severe rhythmic complications (2 auricular fibrillation, 1 flutter, 2 episodes of frequent and polymorphic ESV, 2 TVNS). One patient presented a myocardial infarction during dobutamine echography whereas the basic kinetics was normal. 26 patients got a coronarography within 3 days following echography. Stress echography detected a significant coronary stenosis (> or = 50%), with a sensitivity of 86%, a specificity of 83% and a precision in the diagnosis of 84%.