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实时三维多巴酚丁胺负荷超声心动图评估冠状动脉疾病的初步研究

[Preliminary study of real-time three-dimensional dobutamine stress echocardiography for coronary artery disease assessment].

作者信息

Xu Yong, Liu Jun-song, Zhi Guang, Wang Jing, Ou Shu-lin, Yang Bo, Zhou Xiao, Chen Guang-hui

机构信息

Department of Cardiology, Hainan Branch of Chinese PLA General Hospital, Sanya 572000, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2012 Oct 23;92(39):2747-51.

Abstract

OBJECTIVE

To evaluate the efficacy and safety of real-time three-dimensional dobutamine stress echocardiography for coronary artery disease assessment.

METHODS

A total of 14 patients suspected of coronary artery disease (CAD) underwent real-time three-dimensional dobutamine stress echocardiography. The initial infusion rate of dobutamine was 5 µg×kg⁻¹ ×min⁻¹, followed by 10 µg×kg⁻¹×min⁻¹ and peak infusion 20 µg×kg⁻¹×min⁻¹ in 3 min stages. At baseline state, stress stages and after the study, the real-time three-dimensional (RT3D) images were captured and assessed by wall motion score index (WMSI) and regional ejection fraction (rEF). And the parameters of these two modalities versus coronary angiography (CAG) were compared and analyzed. Adverse reactions were also observed.

RESULTS

All patients completed the stress study uneventfully. As compared with CAG, these two modalities showed no significant difference (P > 0.05) and satisfactory agreement (κ values of 0.704 and 0.759 respectively). The diagnostic parameters of these modalities were: sensitivity (78% vs 89%), specificity (92% vs 88%), positive predictive value (PPV) (88% vs 84%), negative predictive value (NPV) (85% vs 91%) and overall accuracy (86% vs 88%).

CONCLUSION

Real-time three-dimensional dobutamine stress echocardiography is an effective, rapid and safe technique of assessing coronary artery disease. It is worthy of wider clinical applications.

摘要

目的

评估实时三维多巴酚丁胺负荷超声心动图在冠心病评估中的有效性和安全性。

方法

共有14例疑似冠心病(CAD)患者接受了实时三维多巴酚丁胺负荷超声心动图检查。多巴酚丁胺初始输注速率为5μg×kg⁻¹×min⁻¹,随后以3分钟为阶段,依次为10μg×kg⁻¹×min⁻¹,峰值输注速率为20μg×kg⁻¹×min⁻¹。在基线状态、负荷阶段及研究结束后,采集实时三维(RT3D)图像,并通过室壁运动评分指数(WMSI)和节段射血分数(rEF)进行评估。并将这两种方法的参数与冠状动脉造影(CAG)进行比较和分析。同时观察不良反应。

结果

所有患者均顺利完成负荷试验。与CAG相比,这两种方法差异无统计学意义(P>0.05),一致性良好(κ值分别为0.704和0.759)。这些方法的诊断参数为:敏感性(78%对89%)、特异性(92%对88%)、阳性预测值(PPV)(88%对84%)、阴性预测值(NPV)(85%对91%)和总体准确性(86%对88%)。

结论

实时三维多巴酚丁胺负荷超声心动图是一种评估冠心病的有效、快速且安全的技术,值得在临床上更广泛地应用。

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