Usefulness of transesophageal dobutamine stress echocardiography in the detection of ischemic cardiopathy

To assess the usefulness of transesophageal dobutamine stress echocardiography (TEDSE), to identify patients with coronary artery disease. Patients referred for TEDSE with coronary angiography were included. Images were digitized in systolic cine-loop at baseline, with low dose-dobutamine (14.4 +/-...

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Bibliographic Details
Published in:Archivos de cardiología de México 2002-04, Vol.72 (2), p.105-114
Main Authors: Azpiri-López, José Ramón, Assad-Morell, José Luis, Hoyos-Pescador, Roxana, Loera-Torres, Javier, Flores-Coronado, Evangelina
Format: Article
Language:Spanish
Subjects:
Aged
Algorithms
Angina Pectoris - diagnosis
Angina Pectoris - diagnostic imaging
Coronary Angiography
Coronary Disease - diagnosis
Coronary Disease - diagnostic imaging
Data Interpretation, Statistical
Dobutamine
Echocardiography, Transesophageal - methods
Electrocardiography
Female
Heart Diseases - diagnosis
Heart Diseases - diagnostic imaging
Heart Valve Diseases - diagnostic imaging
Humans
Male
Middle Aged
Myocardial Ischemia - diagnosis
Myocardial Ischemia - diagnostic imaging
Sensitivity and Specificity
Sympathomimetics
Time Factors
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Summary:To assess the usefulness of transesophageal dobutamine stress echocardiography (TEDSE), to identify patients with coronary artery disease. 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 micrograms/kg/min), with high dose-dobutamine (28.7 +/- 10.5 micrograms/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 > or = 70% diameter stenosis. 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. 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.
ISSN:1405-9940