Lanzarini L, Previtali M, Ferrario M, Mussini A, Poli A, Fetiveau R, Montemartini C
Divisione di Cardiologia, IRCCS-Policlinico S. Matteo, Università degli studi di Pavia.
G Ital Cardiol. 1992 Aug;22(8):953-61.
The aim of the study was to compare the results of 2D-Echocardiographic (ECHO) vs 12-lead Electrocardiographic (ECG) monitoring during Dobutamine (DOB) infusion performed as a stress test in patients referred for the evaluation of chest pain of suspected ischemic origin. Fourty-seven consecutive patients, 40 m and 7 f, mean age 52 +/- 9 years, were studied after interruption of any antianginal therapy. DOB was infused in 5-minute stages with incremental doses of 5 mcg/kg/min up to a maximal dose of 40 mcg/kg/min. 2D-ECHO monitoring could not be performed in 3 out of 47 patients because of a poor acoustic window. Thus, the overall feasibility was 94% for 2D-ECHO DOB test vs 100% for ECG DOB test (p = ns). The ECG and 2D-ECHO findings were compared in the remaining 44 patients. Criteria for positivity were: transient regional dyssynergy absent or of lesser degree in the baseline examination for 2D-ECHO; ST-segment shift > 0.1 mV from baseline for ECG. The test was stopped when a regional wall motion abnormality developed even in the absence of significant ECG changes. Angiographically assessed coronary artery disease (CAD) was considered significant when a > 50% reduction of the luminal diameter in at least 1 major coronary vessel occurred. There were 10/44 patients with no significant CAD and 34/44 patients with CAD; 16 had single, 18 double or triple and/or left main vessel disease.(ABSTRACT TRUNCATED AT 250 WORDS)
本研究的目的是比较在对因疑似缺血性起源胸痛而转诊的患者进行多巴酚丁胺(DOB)负荷试验时,二维超声心动图(ECHO)与12导联心电图(ECG)监测的结果。连续纳入47例患者,其中男性40例,女性7例,平均年龄52±9岁,在中断任何抗心绞痛治疗后进行研究。DOB以5μg/kg/min的递增剂量分5分钟阶段输注,最大剂量为40μg/kg/min。47例患者中有3例因声窗不佳无法进行二维超声心动图监测。因此,二维超声心动图DOB试验的总体可行性为94%,而心电图DOB试验为100%(p=无显著性差异)。对其余44例患者的心电图和二维超声心动图结果进行了比较。阳性标准为:二维超声心动图基线检查时短暂性节段性运动失调不存在或程度较轻;心电图ST段移位>0.1mV(相对于基线)。即使在无明显心电图变化的情况下出现节段性室壁运动异常,试验即停止。当至少1支主要冠状动脉管腔直径减少>50%时,血管造影评估的冠状动脉疾病(CAD)被认为具有显著性。44例患者中10例无显著性CAD,34例有CAD;16例为单支血管病变,18例为双支或三支血管病变和/或左主干血管病变。(摘要截短至250字)