Sahin M, Karakelleoğlu S, Alp N, Ateşal S, Senocak H
Department of Cardiology, School of Medicine, Atatürk University, Erzurum, Turkey.
Thorac Cardiovasc Surg. 1994 Oct;42(5):285-9. doi: 10.1055/s-2007-1016506.
In order to assess the value of dobutamine stress echocardiography (DSE) for detecting coronary artery disease (CAD), 67 consecutive patients (mean age +/- SD was 58 +/- 8 years, range 35 to 75; 46 men and 21 women) with known or suspected CAD undergoing selective coronary angiography within the week following the DSE were studied. Two patients were excluded from the study because of insufficient echocardiographic imaging. Dobutamine (5 to 30 micrograms/kg/min by 5 micrograms/kg/min increments) was infused in 5-minute intervals. All the patients had 12-lead electrocardiogram (ECG) recorded at rest and at each stage of dobutamine infusion. There was significant CAD (> or = 50% diameter stenosis) in 42 patients (64.6%) with 16 patients having 1-vessel, 7 patients having 2-vessel and 19 patients having 3-vessel CAD. In 22 patients coronary angiogram was normal. DSE was positive in 33 of 42 patients with CAD. The test was negative in 20 of 23 patients without CAD. Compared with coronary angiography, the overall sensitivity of DSE for detecting CAD was 78.6% specificity 87%, positive predictive value 91.7%, negative predictive value 69%, and accuracy 81.5%. The sensitivity in those with one-vessel, two-vessel, three-vessel and multivessel disease was 62.5%, 85.7%, 94.7%, and 92.3% respectively. DSE was well tolerated in all patients. The study was not prematurely terminated due to a side effect in any patient. This study indicated that DSE is a practical method for the non-invasive assessment of significant CAD, for determining the patients who require invasive tests, and for predicting the extent of disease.(ABSTRACT TRUNCATED AT 250 WORDS)
为评估多巴酚丁胺负荷超声心动图（DSE）检测冠状动脉疾病（CAD）的价值，对67例连续的已知或疑似CAD患者（平均年龄±标准差为58±8岁，范围35至75岁；46例男性和21例女性）进行了研究，这些患者在DSE后的一周内接受选择性冠状动脉造影。两名患者因超声心动图成像不足被排除在研究之外。以5微克/千克/分钟的增量，每隔5分钟输注多巴酚丁胺（5至30微克/千克/分钟）。所有患者在静息状态和多巴酚丁胺输注的每个阶段均记录12导联心电图（ECG）。42例患者（64.6%）存在显著CAD（直径狭窄≥50%），其中16例为单支血管病变，7例为双支血管病变，19例为三支血管病变。22例患者冠状动脉造影正常。42例CAD患者中33例DSE呈阳性。23例无CAD患者中20例检测为阴性。与冠状动脉造影相比，DSE检测CAD的总体敏感性为78.6%，特异性为87%，阳性预测值为91.7%，阴性预测值为69%，准确性为81.5%。单支血管、双支血管、三支血管和多支血管疾病患者的敏感性分别为62.5%、85.7%、94.7%和92.3%。所有患者对DSE耐受性良好。没有任何患者因副作用导致研究提前终止。该研究表明，DSE是一种用于无创评估显著CAD、确定需要进行有创检查的患者以及预测疾病范围的实用方法。（摘要截断于250字）
