Lamisse N, Cohen A, Chauvel C, Benhalima B, Désert I, Buyukoglu B, Blanchard B, Albo C, Boccara F, Valty J
Service de cardiologie, Hôpital Saint-Antoine, Paris.
Arch Mal Coeur Vaiss. 1997 Nov;90(11):1455-61.
The increasing indications of dobutamine stress echo in the investigation of myocardial ischaemia, viability and evaluation of the prognosis of coronary artery disease has made this technique a tool of everyday clinical practice. The authors reviewed the results of 600 investigations in consecutive unselected including patients aged over 75. No significant difference was observed with respect to the causes of interruption of the test between patients aged less than 75 (521 patients) and those older than 75 (79 patients). Attaining the target theoretical maximal heart rate was the commonest reason for stopping the test (47 and 48% respectively). Ventricular arrhythmias were not more common (12 and 10% respectively). Twelve cases of ventricular tachycardia were observed, 8 of which were non-sustained; 9 led to interruption of the test. No cases of ventricular fibrillation were observed. A previous history of cardiac arrhythmias was not associated with a higher frequency of arrhythmia during the test (8% in those with a previous history, 4% in those patients without). Supraventricular arrhythmias were significantly more common in patients over 75 years of age (15 versus 8%, p = 0.046). Dobutamine stress echocardiography' is feasible in a population of unselected patients, including those over 75. Therefore, age does not represent a limitation to the extension of this investigation.
多巴酚丁胺负荷超声心动图在心肌缺血、存活心肌检测及冠心病预后评估方面的应用日益广泛,已成为日常临床实践中的一项工具。作者回顾了对600例未经筛选的连续患者(包括75岁以上患者)进行检查的结果。年龄小于75岁的患者(521例)和年龄大于75岁的患者(79例)在检查中断原因方面未观察到显著差异。达到目标理论最大心率是停止检查最常见的原因(分别为47%和48%)。室性心律失常并不更常见(分别为12%和10%)。观察到12例室性心动过速,其中8例为非持续性;9例导致检查中断。未观察到心室颤动病例。既往有心脏心律失常病史与检查期间心律失常的较高发生率无关(有既往病史者为8%,无既往病史者为4%)。75岁以上患者的室上性心律失常明显更常见(15%对8%,p = 0.046)。多巴酚丁胺负荷超声心动图在未经筛选的患者群体中,包括75岁以上患者中是可行的。因此,年龄并不限制这项检查的推广。