Dionisopoulos P N, Collins J D, Smart S C, Knickelbine T A, Sagar K B
Division of Cardiology, Medical College of Wisconsin, Milwaukee 53226, USA.
J Am Soc Echocardiogr. 1997 Oct;10(8):811-7. doi: 10.1016/s0894-7317(97)70040-3.
To determine whether there were any gender-based differences in the detection of coronary artery disease by dobutamine stress echocardiography, we examined 288 patients (187 men and 101 women) who underwent coronary angiography within 8 weeks of dobutamine stress testing. Abnormal test results were indicated by let ventricular wall motion abnormalities at rest, which did not improve or worsen, or inducible wall motion abnormalities in two or more segments with dobutamine. Overall, dobutamine stress echocardiography showed a high sensitivity, specificity, and accuracy in both men and women: 85%, 96%, and 88% anx 90%, 79%, and 86%, respectively. The sensitivity in detecting significant coronary artery disease in our population was not influenced by gender. However, the sensitivity of the test was influenced by the extent and location of coronary disease and the pattern of left ventricular, hypertrophy. The sensitivity was 80% in patients with single-vessel disease, whereas the sensitivity was 91% in patients with multivessel disease. In addition, patients with single-vessel disease had lower sensitivity when the abnormality was located in the left circumflex coronary artery territory (59% versus 86% in the left anterior descending and right coronary territories). Our data indicated that there is no gender-based difference in the sensitivity and specificity of dobutamine stress echocardiography in detecting coronary artery disease and that the limitations of the test should be attributed to the extent and location of coronary disease.
为了确定多巴酚丁胺负荷超声心动图检测冠心病是否存在性别差异，我们对288例患者（187例男性和101例女性）进行了研究，这些患者在多巴酚丁胺负荷试验后8周内接受了冠状动脉造影。静息时左心室壁运动异常、未改善或恶化，或多巴酚丁胺诱发两个或更多节段的壁运动异常均提示检查结果异常。总体而言，多巴酚丁胺负荷超声心动图在男性和女性中均显示出高敏感性、特异性和准确性：分别为85%、96%和88%以及90%、79%和86%。在我们的研究人群中，检测显著冠状动脉疾病的敏感性不受性别影响。然而，该检查的敏感性受冠状动脉疾病的范围和部位以及左心室肥厚模式的影响。单支血管疾病患者的敏感性为80%，而多支血管疾病患者的敏感性为91%。此外，当异常位于左旋支冠状动脉区域时，单支血管疾病患者的敏感性较低（左前降支和右冠状动脉区域分别为59%对86%）。我们的数据表明，多巴酚丁胺负荷超声心动图检测冠心病的敏感性和特异性不存在性别差异，该检查的局限性应归因于冠状动脉疾病的范围和部位。
