Value and limitations of dobutamine stress echocardiography in women with suspected coronary artery disease

• Published in: Zeitschrift für Herz-, Thorax- und Gefässchirurgie Thorax- und Gefässchirurgie, 2007-12, Vol.21 (6), p.250-258
• Main Authors: Lehmkuhl, H. B., Siniawski, H., Lehmkuhl, E., Dandel, M., Regitz-Zagrosek, V., Hetzer, R.
• Format: Article
• Language: English
• Subjects: Accuracy; Cardiovascular disease; Coronary vessels; Electrocardiography; Vein & artery diseases
• ISSN: 0930-9225; 1435-1277
• DOI: 10.1007/s00398-007-0598-9

AbstractThe accuracy of exercise electrocardiography (ECG) for detecting coronary artery disease (CAD) in women is limited. Dobutamine stress echocardiography (DSE) is an alternative. Limited and conflicting data exist on the utility of DSE. This prospective study determines value and limitations of DSE compared with exercise ECG in women with suspected CAD.A total of 114 consecutive women without previous myocardial infarction underwent standard exercise ECG and DSE prior to coronary angiography performed within 5±2 days. Pretest probability of CAD was calculated from clinical parameters and significant CAD was defined as ≥50% coronary artery luminal narrowing.Prevalence of CAD was 39.5% with multivessel disease in 49%. Most patients had a low or intermediate pretest probability of CAD (75%). Exercise ECG recordings were diagnostic in 71% and DSE in 90% of women. Overall sensitivity, specificity and accuracy for DSE were superior to exercise ECG (80%, 81%, and 80%, respectively, versus 65%, 55%, and 59%, respectively; p