Dayoub G, André-Fouet X, Perinetti M, Amaya J, Nony P, Desseigne P, Roriz R, Delahaye F, Delaye J
Hôpital Cardio-vasculaire et Pneumologique Louis-Pradel, BP Lyon-Monchat.
Ann Cardiol Angeiol (Paris). 1996 Nov;45(9):489-94.
In order to evaluate the place of dobutamine echocardiography in everyday practice, this test and a stress ECG were performed in 34 patients referred for diagnostic or assessment coronary angiography. Dobutamine, administered in 3-minute stages from 5 to 30 micrograms/kg/min, was well tolerated. The anti-ischaemic treatment was continued in 26 patients before dobutamine echocardiography and in 15 patients before the stress ECG. The electrocardiographic, echocardiographic and angiographic documents were each analysed by 2 independent observers. Dobutamine echocardiography was considered to be positive in the presence of the development of a new abnormality of segmental kinetics or when abnormality of segmental kinetics was identified outside of the territory of infarction. With reference to coronary angiography, the sensitivity of stress ECG and dobutamine echocardiography was 46% and 42%, respectively, and the specificity was 75% and 88%, respectively; the sensitivity of each test was low, probably because of fake tests. The combination of the two tests improved the sensitivity (69%) without altering the specificity (75%). Dobutamine echocardiography could usefully complete a negative stress ICG whenever a false-negative result is suspected to avoir wrongly reassuring some patients and to allow appropriate management.
为了评估多巴酚丁胺超声心动图在日常实践中的地位，对34例因诊断或评估冠状动脉造影而转诊的患者进行了此项检查及运动心电图检查。以5至30微克/千克/分钟的剂量分3分钟阶段给予多巴酚丁胺，耐受性良好。26例患者在多巴酚丁胺超声心动图检查前继续进行抗缺血治疗，15例患者在运动心电图检查前继续进行抗缺血治疗。心电图、超声心动图和血管造影文件分别由2名独立观察者进行分析。当出现新的节段性动力学异常或在梗死区域外发现节段性动力学异常时，多巴酚丁胺超声心动图被认为是阳性的。参照冠状动脉造影，运动心电图和多巴酚丁胺超声心动图的敏感性分别为46%和42%，特异性分别为75%和88%；每项检查的敏感性都较低，可能是因为存在假阴性检查结果。两项检查联合使用可提高敏感性（69%），而不改变特异性（75%）。每当怀疑运动心电图出现假阴性结果时，多巴酚丁胺超声心动图可有效地补充运动心电图检查，以避免错误地让一些患者放心，并进行适当的管理。
