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Diagnostic value of 12-lead electrocardiogram during dobutamine echocardiographic studies
J Shaheen1, D Luria, M W Klutstein
1Department of Cardiology, Jesselson Heart Center, Shaare Zedek Medical Center, Jerusalem, Israel.
Background:
The diagnostic value of 12-lead electrocardiography during dobutamine stress echocardiography (DSE) is not well documented.
Methods And Results:
We reviewed the records of 116 patients referred for DSE and coronary angiography, 52 of whom were excluded because of abnormal ST segment or inadequate DSE. Of the analyzed 65 patients, 42 had angiographic evidence of significant coronary disease, 41 had evidence of ischemia according to the echocardiographic criteria, and 30 had ST changes during the study. DSE had sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 88%, 81%, 90%, and 78%, respectively. Twelve-lead electrocardiography had sensitivity, specificity, PPV, and NPV of 52%, 64%, 72%, and 41%, respectively. NPV increased to 92% in patients with negative DSE and negative ST changes. PPV increased to 95% if both DSE and 12-lead electrocardiographic ischemic changes were observed.
Conclusions:
Twelve-lead electrocardiography has an incremental diagnostic value when used during DSE.