Dobutamine stress echocardiography compared with dipyridamole thallium-201 single-photon emission computed tomography in detecting coronary artery disease

To compare the diagnostic value of dobutamine stress echocardiography with dipyridamole thallium-201 single-photon emission computed tomography (SPECT) in detecting coronary artery disease (CAD), we performed both tests on 54 patients who also underwent coronary arteriography. Dobutamine was infused...

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Published in:European heart journal 1995-04, Vol.16 (4), p.570-575
Main Authors: Ho, F.-M., HUANG, P.-J., LIAU, C.-S., LEE, F.-K., CHIENG, P.-U., SU, C.-T., LEE, Y.-T.
Format: Article
Language:English
Subjects:
Adult
Aged
Biological and medical sciences
Cardiology. Vascular system
Coronary Angiography
Coronary artery disease
Coronary Disease - diagnosis
Coronary heart disease
Dipyridamole
dipyridamole thallium-201 SPECT
Dobutamine
dobutamine stress echocardiography
Echocardiography - methods
Electrocardiography
Female
Heart
Humans
Male
Medical sciences
Middle Aged
Sensitivity and Specificity
Stress, Physiological
Thallium Radioisotopes
Tomography, Emission-Computed, Single-Photon - methods
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container_issue 4
container_start_page 570
container_title European heart journal
container_volume 16
creator Ho, F.-M.
HUANG, P.-J.
LIAU, C.-S.
LEE, F.-K.
CHIENG, P.-U.
SU, C.-T.
LEE, Y.-T.
description To compare the diagnostic value of dobutamine stress echocardiography with dipyridamole thallium-201 single-photon emission computed tomography (SPECT) in detecting coronary artery disease (CAD), we performed both tests on 54 patients who also underwent coronary arteriography. Dobutamine was infused at an incremental regimen of 5,10,20,30 and 40 μg. kg-1. min-1. Dipyridamole was infused at a rate of 0.14 mg. kg-1. min-1 over 4 min. Dobutamine stress echocardiography detected 40 (93%) and SPECT 42 (98%, P=ns) of the 43 patients with significant CAD, defined as (greater than or equal) 50% diameter stenosis. The specificity was 73% (8 of 11) for both tests. The sensitivity for detecting individual coronary artery stenosis with dobutamine stress echocardiography was 81% (30 of 37) for the left anterior descending artery, 75% (24 of 32) for the right coronary artery, and 61% (17 of 28) for the left circumflex artery. For SPECT it was 89%, 97% (P>0.05 vs dobutamine stress echocardiography) and 75%, respectively. Among the 97 stenotic coronary arteries, 17 had mild to moderate stenosis (50%-69% diameter stenosis) and 80 had severe stenosis ($$70% diameter stenosis). With dobutamine stress echocardiography, 53% of the arteries with mild to moderate stenosis were identified vs 78% of those with severe stenosis (P
doi_str_mv 10.1093/oxfordjournals.eurheartj.a060952
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Dobutamine was infused at an incremental regimen of 5,10,20,30 and 40 μg. kg-1. min-1. Dipyridamole was infused at a rate of 0.14 mg. kg-1. min-1 over 4 min. Dobutamine stress echocardiography detected 40 (93%) and SPECT 42 (98%, P=ns) of the 43 patients with significant CAD, defined as (greater than or equal) 50% diameter stenosis. The specificity was 73% (8 of 11) for both tests. The sensitivity for detecting individual coronary artery stenosis with dobutamine stress echocardiography was 81% (30 of 37) for the left anterior descending artery, 75% (24 of 32) for the right coronary artery, and 61% (17 of 28) for the left circumflex artery. For SPECT it was 89%, 97% (P&gt;0.05 vs dobutamine stress echocardiography) and 75%, respectively. Among the 97 stenotic coronary arteries, 17 had mild to moderate stenosis (50%-69% diameter stenosis) and 80 had severe stenosis ($$70% diameter stenosis). With dobutamine stress echocardiography, 53% of the arteries with mild to moderate stenosis were identified vs 78% of those with severe stenosis (P&lt;0.05). With SPECT, the sensitivity was 82% (14 of 17) in mild to moderate stenosis and 89% (71 of 80) in severe stenosis (P=ns). No major side effects occurred during either test. Thus, both dobutamine stress and SPECT are highly sensitive for detection and localization of CAD. However, the sensitivity of dobutamine stress is affected by the level of stenosis severity.</abstract><cop>Oxford</cop><pub>Oxford University Press</pub><pmid>7671905</pmid><doi>10.1093/oxfordjournals.eurheartj.a060952</doi><tpages>6</tpages></addata></record>
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identifier ISSN: 0195-668X
ispartof European heart journal, 1995-04, Vol.16 (4), p.570-575
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1522-9645
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source Oxford University Press Archive
subjects Adult
Aged
Biological and medical sciences
Cardiology. Vascular system
Coronary Angiography
Coronary artery disease
Coronary Disease - diagnosis
Coronary heart disease
Dipyridamole
dipyridamole thallium-201 SPECT
Dobutamine
dobutamine stress echocardiography
Echocardiography - methods
Electrocardiography
Female
Heart
Humans
Male
Medical sciences
Middle Aged
Sensitivity and Specificity
Stress, Physiological
Thallium Radioisotopes
Tomography, Emission-Computed, Single-Photon - methods
title Dobutamine stress echocardiography compared with dipyridamole thallium-201 single-photon emission computed tomography in detecting coronary artery disease
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