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[Dobutamine stress echocardiography; a monocentric experience on 600 consecutive patients. Effect of age]
Insights
Dobutamine stress echocardiography is a safe and effective tool for assessing coronary artery disease in patients over 75. Age is not a limitation for this diagnostic procedure.
Area of Science:
- Cardiology
- Diagnostic Imaging
Background:
- Dobutamine stress echocardiography (DSE) is increasingly used for myocardial ischemia, viability, and coronary artery disease prognosis.
- Its utility in elderly populations requires further investigation.
Purpose of the Study:
- To evaluate the feasibility and safety of DSE in unselected patients, specifically including those over 75 years of age.
Main Methods:
- Retrospective review of 600 DSE investigations in consecutive patients.
- Comparison of test interruption causes and arrhythmias between patients <75 and >=75 years old.
Main Results:
- No significant difference in test interruption causes between age groups.
- Attaining target heart rate was the most common reason for test cessation.
- Supraventricular arrhythmias were more frequent in patients over 75 (15% vs 8%, p=0.046).
- Ventricular arrhythmias and ventricular fibrillation were not more common in older patients.
Conclusions:
- Dobutamine stress echocardiography is feasible and safe in unselected elderly patients.
- Age is not a limitation for performing DSE in clinical practice.
Abstract:
The increasing indications of dobutamine stress echo in the investigation of myocardial ischaemia, viability and evaluation of the prognosis of coronary artery disease has made this technique a tool of everyday clinical practice. The authors reviewed the results of 600 investigations in consecutive unselected including patients aged over 75. No significant difference was observed with respect to the causes of interruption of the test between patients aged less than 75 (521 patients) and those older than 75 (79 patients). Attaining the target theoretical maximal heart rate was the commonest reason for stopping the test (47 and 48% respectively). Ventricular arrhythmias were not more common (12 and 10% respectively). Twelve cases of ventricular tachycardia were observed, 8 of which were non-sustained; 9 led to interruption of the test. No cases of ventricular fibrillation were observed. A previous history of cardiac arrhythmias was not associated with a higher frequency of arrhythmia during the test (8% in those with a previous history, 4% in those patients without). Supraventricular arrhythmias were significantly more common in patients over 75 years of age (15 versus 8%, p = 0.046). Dobutamine stress echocardiography' is feasible in a population of unselected patients, including those over 75. Therefore, age does not represent a limitation to the extension of this investigation.