Kraiem Sondos, Hmem Mohamed, Annabi Nizar, Slimane Mohamed Lotfi
Service de cardiologie, Hôpital Habib Thameur.
Tunis Med. 2007 Jan;85(1):42-8.
The dobutamine echocardiography takes more and more an important place in diagnosis, prognosis and therapeutics strategies of the coronary disease.
We prospectively enrolled 130 consecutive patients followed for a coronary insufficiency
the aim of determinating the diagnostic value of the dobutamine echocardiography in the myocardial ischemia compared with the classic means as the exercise test and the myocardial scintigraphy.
Our results are comparable to the data of the literature, the dobutamine echocardiography is more specific than the exercise test and the myocardial scintigraphy (96 %, 61% and 53 %), more sensitive than exercise test (75 % versus 47 %) but less sensitive than the myocardial scintigraphy (75 % versus 96 %). The stress echocardiography has the best diagnosis precision 87% against 72 % for the scintigraphy and 56 % for the exercise test. The dobutamine echocardiography is a very feasible, tolerated well exam and especially very reliable in term of detection of the coronary disease in the feminine population, with a sensibility at 66,7 %, a specificity at 100 % and a diagnostic precision at 92 %, also in patient with hypertension the stress echocardiography is much more specific and reliable than the exercise test (100 % vs 22 % and 93 % vs 54 %, respectively),and it's superior to the exercise test in the presence of electric signs of systolic excess load and to the myocardial scintigraphy in case of left ventricular hypertrophy. The dobutamine echocardiography can be considered as safety and reliable means of investigation of the coronary insufficiency .
多巴酚丁胺超声心动图在冠心病的诊断、预后及治疗策略中发挥着越来越重要的作用。
我们前瞻性纳入了130例连续的冠心病患者。
旨在确定多巴酚丁胺超声心动图在心肌缺血诊断中的价值，并与运动试验和心肌闪烁显像等传统方法进行比较。
我们的结果与文献数据相当，多巴酚丁胺超声心动图比运动试验和心肌闪烁显像更具特异性（分别为96%、61%和53%），比运动试验更敏感（75%对47%），但比心肌闪烁显像敏感性低（75%对96%）。负荷超声心动图具有最佳的诊断准确性，为87%，而闪烁显像为72%，运动试验为56%。多巴酚丁胺超声心动图是一种非常可行、耐受性良好的检查，在女性人群中检测冠心病方面尤其可靠，敏感性为66.7%，特异性为100%，诊断准确性为92%。在高血压患者中，负荷超声心动图也比运动试验更具特异性和可靠性（分别为100%对22%和93%对54%），在存在收缩期负荷过重的电信号时优于运动试验，在左心室肥厚的情况下优于心肌闪烁显像。多巴酚丁胺超声心动图可被视为冠心病检查的安全可靠手段。
