[Dobutamine exercise echocardiography versus SPECT in diagnosing ischemic heart disease]

The aim of the study was comparison of dobutamine stress echocardiography with SPECT in the assessment of ischemic heart disease.

It is a retrospective study analysing 119 patients (72 women and 47 men, mean age 56.9 +/- 10.68 years), who underwent dobutamine stress echocardiography and SPECT. Because of inconclusive findings (LBBB, decreased myocardial perfusion by SPECT depending on the position of the body), 23 patients were excluded.

In the whole group of 96 patients the diagnostic validity of dobutamine stress echocardiography was as follows: sensitivity 78%, specificity 93%, positive predictive value 89%, negative predictive value 85%, and kappa value 0.71. In women the sensitivity was 69%, specificity 93%, positive predictive value 79%, negative predictive value 89%, and kappa value 0.64. In men the diagnostic validity was: sensitivity 83%, specificity 92%, positive predictive value 95%, negative predictive value 73%, and kappa value 0.70.

In conclusion, dobutamine stress echocardiography is highly sensitive and specific method in the diagnosis of ischemic heart disease with good agreement when compared with SPECT. Because of availability and lower cost in comparison with SPECT, dobutamine stress echocardiography is an optimal method in the diagnosis and management of patients with ischemic heart disease in routine clinical practice.