Department of Cardiology, Pôle V Thorax Vasculaire Digestif Métabolisme, Centre de Référence pour les Maladies Cardiaques Héréditaires, Université de Versailles-Saint Quentin, Hôpital Ambroise Paré, Assistance Publique-Hôpitaux de Paris, Boulogne, France.
Am J Cardiol. 2012 Mar 15;109(6):800-4. doi: 10.1016/j.amjcard.2011.10.044. Epub 2011 Dec 19.
The aim of this study was to assess the prevalence of coronary artery spasm during dobutamine stress echocardiography (DSE). Over a 9-year period (from November 2001 to October 2010) we reviewed all patients (n = 2,224) referred for DSE. Criteria for selection included patients > 18 years old who underwent DSE. We systematically analyzed all electrocardiograms obtained during DSE to detect ST-segment elevation during the examination. All patients with ST-segment elevation underwent coronary angiography. DSE was performed in 2,179 patients. ST-segment elevation was observed in 21 patients, all of whom underwent emergency coronary angiography. In 13 of these 21 patients (62%) significant coronary stenosis was observed: 6 patients with critical coronary stenosis and 7 patients with chronic coronary occlusion. The remaining 8 patients (38% of patients presenting with ST-segment elevation during DSE, 7 men, mean age 67 ± 11 years) had no significant coronary stenosis. Prevalence of coronary artery spasm during DSE was 0.4%. In conclusion, physicians should be aware that, although rare, coronary artery spasm may occur during DSE.
本研究旨在评估多巴酚丁胺负荷超声心动图（DSE）期间冠状动脉痉挛的发生率。在 9 年期间（2001 年 11 月至 2010 年 10 月），我们回顾了所有接受 DSE 检查的患者（n=2224）。入选标准包括年龄大于 18 岁并接受 DSE 检查的患者。我们系统地分析了 DSE 期间获得的所有心电图，以检测检查过程中的 ST 段抬高。所有出现 ST 段抬高的患者均接受冠状动脉造影。在 2179 例患者中进行了 DSE。21 例患者出现 ST 段抬高，所有患者均接受了紧急冠状动脉造影。在这 21 例患者中，有 13 例（62%）观察到显著的冠状动脉狭窄：6 例患者存在临界冠状动脉狭窄，7 例患者存在慢性冠状动脉闭塞。其余 8 例患者（出现 DSE 期间 ST 段抬高患者的 38%，7 名男性，平均年龄 67±11 岁）无明显冠状动脉狭窄。DSE 期间冠状动脉痉挛的发生率为 0.4%。结论：尽管罕见，但医生应意识到，在 DSE 期间可能会发生冠状动脉痉挛。
