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[Detection of myocardial ischemia during dobutamine stress echocardiography. Correlation with coronary
W Mathias Júnior1, E H Doya, E E Ribeiro
1Hospital Unicor, São Paulo.
Insights
Dobutamine stress echocardiography (DSE) is a safe and effective method for detecting myocardial ischemia, demonstrating high accuracy and a low complication rate in clinical practice.
Area of Science:
- Cardiology
- Diagnostic Imaging
- Echocardiography
Background:
- Myocardial ischemia detection is crucial for cardiovascular disease management.
- Dobutamine stress echocardiography (DSE) is a non-invasive imaging technique used to assess cardiac function under stress.
- Evaluating the diagnostic performance of DSE for identifying ischemia is essential.
Purpose of the Study:
- To assess the efficacy of dobutamine stress echocardiography (DSE) in detecting myocardial ischemia.
- To determine the sensitivity, specificity, and accuracy of DSE compared to coronary angiography.
Main Methods:
- A study involving 271 patients undergoing DSE.
- Coronary angiography was performed on 63 patients within one month of DSE.
- Angiograms were analyzed for coronary lesions >50% luminal occlusion.
Main Results:
- DSE achieved a global sensitivity of 95% and specificity of 75%, with 89% accuracy.
- Among 43 patients with obstructive coronary artery disease, DSE had 2 false negatives.
- Common side effects included palpitations (46%) and arrhythmia (24%); severe hypotension was rare (0.4%).
Conclusions:
- DSE is a safe and promising method for detecting myocardial ischemia.
- The low complication rate and high accuracy support the clinical utility of DSE.
- DSE offers a feasible approach for diagnosing ischemia in patients with suspected coronary artery disease.
Purpose:
To detect myocardial ischemia during dobutamine stress echocardiography (DSE).
Methods:
Two hundred and seventy one patients were studied; 63 (23%) underwent coronary angiography within a month of DSE. Angiograms were analyzed independently by 3 angiographers, and coronary lesions larger than 50% of luminal occlusion were considered likely to cause ischemia.
Results:
The global sensitivity and specificity were 95% and 75% respectively, with 89% accuracy. Of 43 patients showing obstructive coronary artery disease, there were 2 false negatives. One of 5 false positives had ischemic cardiomyopathy and another a technically difficult exam. The symptoms and side effects in decreasing order of occurrence are as follows: palpitation 46%; arrhythmia 24%; mild hypotension 24%; chest pain 8%; hypertension 5%; facial paresthesia 4%; chills 1.8%; nausea 1.8%; headache 1.4%; dyspnea 0.4% and severe hypotension 0.4%.
Conclusion:
Considering the results, the small number of complications and the feasibility, DSE seems to be a safe and promising method for detecting myocardial ischemia.