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2002, Número 2

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Arch Cardiol Mex 2002; 72 (2)


Utilidad de la ecocardiografía omniplanar transesofágica de stress con dobutamina en la detección de cardiopatía isquémica

Azpiri-López JR, Assad-Morell JL, Hoyos-Pescador R, Loera-Torres J, Flores-Coronado E

Idioma: Español
Referencias bibliográficas: 46
Paginas: 105-114
Archivo PDF: 264.48 Kb.


RESUMEN

Objetivos: Evaluar la utilidad de la ecocardiografía transesofágica de stress con dobutamina (ETESD) para la identificación de cardiopatía isquémica. Métodos: Se estudiaron pacientes referidos para ETESD con angiografía coronaria. Las imágenes fueron digitalizadas en cine-loop sistólico en estado basal, a dosis bajas de dobutamina (14.4 ± 5 µg/kg/min), dosis altas (28.7 ± 10.5 µg/kg/min) y en la recuperación, para análisis por dos observadores. Se dividió el ventrículo izquierdo en 16 segmentos de acuerdo a su irrigación y se consideró el estudio anormal si hubo desarrollo o empeoramiento de los trastornos de la contractilidad segmentaria. Las angiografías coronarias cuantitativas se evaluaron independientemente, considerándose lesiones significativas aquéllas ≥ 70%. Resultados: Se incluyeron 68 pacientes. La sensibilidad, especificidad y exactitud del ETESD fueron de 93%, 89.7% y 91.1%, respectivamente. El estudio detectó 7/7 pacientes con lesión de un vaso y 20/22 con enfermedad de vasos múltiples. El ECG de 12 derivaciones tuvo sensibilidad de 38.8%, especificidad de 91.8% y exactitud de 74.5% para la detección de las mismas lesiones. Conclusiones: El ETESD es un método asequible, seguro, sensible y específico con alta capacidad para detectar estenosis coronarias significativas. Su uso debe ser considerado en pacientes con mala ventana acústica transtorácica o pobre visualización de los bordes endocárdicos.


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