Mathias Júnior W, Doya E H, Ribeiro E E, Silva L A, Gasques A, Salvadori R A, Duprat Filho R
Hospital Unicor, São Paulo.
Arq Bras Cardiol. 1993 Apr;60(4):229-34.
To detect myocardial ischemia during dobutamine stress echocardiography (DSE).
Two hundred and seventy one patients were studied; 63 (23%) underwent coronary angiography within a month of DSE. Angiograms were analyzed independently by 3 angiographers, and coronary lesions larger than 50% of luminal occlusion were considered likely to cause ischemia.
The global sensitivity and specificity were 95% and 75% respectively, with 89% accuracy. Of 43 patients showing obstructive coronary artery disease, there were 2 false negatives. One of 5 false positives had ischemic cardiomyopathy and another a technically difficult exam. The symptoms and side effects in decreasing order of occurrence are as follows: palpitation 46%; arrhythmia 24%; mild hypotension 24%; chest pain 8%; hypertension 5%; facial paresthesia 4%; chills 1.8%; nausea 1.8%; headache 1.4%; dyspnea 0.4% and severe hypotension 0.4%.
Considering the results, the small number of complications and the feasibility, DSE seems to be a safe and promising method for detecting myocardial ischemia.
