[Usefulness of transesophageal dobutamine stress echocardiography in the detection of ischemic cardiopathy].

Autor:	Azpiri-López JR; Hospital Christus Muguerza de Monterrey, Calle Hidalgo No. 2525 Pte., Monterrey, N.L., México C.P. 64060. jazpiri@infosel.net.mx, Assad-Morell JL, Hoyos-Pescador R, Loera-Torres J, Flores-Coronado E
Jazyk:	Spanish; Castilian
Zdroj:	Archivos de cardiologia de Mexico [Arch Cardiol Mex] 2002 Apr-Jun; Vol. 72 (2), pp. 105-14.
Abstrakt:	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 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. 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.
Databáze:	MEDLINE
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