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2002, Number 2

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Arch Cardiol Mex 2002; 72 (2)

Usefulness of transesophageal dobutamine stress echocardiography to detect ischemic heart disease

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

Language: Spanish
References: 46
Page: 105-114
PDF size: 264.48 Kb.


ABSTRACT

Objective: To assess the usefulness of transesophageal dobutamine stress echocardiography (TEDSE), to identify patients with coronary artery disease. Methods: Patients referred for TEDSE with coronary angiography were included. Images were digitized in systolic cine-loop at baseline, with low dose-dobutamine (14.4 ± 5 µg/kg/min), with high dose-dobutamine (28.7 ± 10.5 µg/kg/min) and during recovery, and then analyzed by two observers. The left ventricle was divided into 16 segments according to coronary distribution, and the study was considered abnormal if there was a new or worsening of the segmental wall motion abnormality. Quantitative coronary angiographies were independently assessed, and lesions considered significant if they had ≥ 70% diameter stenosis. Results: Sixty eight patients were included. TEDSE sensitivity, specificity, and accuracy were 93%, 89.7%, and 91.1%, respectively. TEDSE correctly detected 7/7 single vessel disease and 20/22 multiple vessel disease patients. Twelve-lead ECG had a sensitivity, specificity, and accuracy of 38.3%, 91.8%, and 74.5% respectively, to detect the same lesions. Conclusions: TEDSE is feasible, safe, sensitive, and specific to detect significant coronary lesions. It should be considered in patients with suboptimal acoustic window or poor visualization of endocardial borders.


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