Prognostic value of dobutamine stress echocardiography in patients referred because of suspected coronary artery disease
| Autor: | Neal V. Dawson, Mohammed Kamaran, Robert S. Finkelhor, Steven M. Teague, Robert C. Bahler |
|---|---|
| Rok vydání: | 1995 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Coronary Disease Revascularization Chest pain Angina Coronary artery disease Predictive Value of Tests Internal medicine Dobutamine medicine Humans Myocardial infarction Aged Retrospective Studies Ultrasonography business.industry Perioperative Middle Aged medicine.disease Prognosis Survival Rate Predictive value of tests Cardiology Female medicine.symptom Cardiology and Cardiovascular Medicine business medicine.drug |
| Zdroj: | The American journal of cardiology. 76(12) |
| ISSN: | 0002-9149 |
| Popis: | To determine whether dobutamine stress echocardiography (DSE) provides prognostic information beyond that available from routine clinical data, we reviewed the outcome of 210 consecutive patients referred for DSE to evaluate chest pain, perioperative risk, and myocardial viability. Dobutamine was infused in increments of 10 micrograms/kg/min in 5-minute stages to a maximum of 40 micrograms/kg/min. The dobutamine stress echocardiogram was considered abnormal only if dobutamine induced a new wall motion abnormality as determined by review of the digitized echocardiographic images in a quad screen format and on videotape. Thirty percent of tests were abnormal. An abnormal test was more common (por = 0.02) in men and patients with angina pectoris, in patients taking nitrate therapy, or those with prior myocardial infarction or abnormal left ventricular wall motion at rest. Twenty-two deaths, 17 of which were cardiac, occurred over a median follow-up of 240 days (range 30 to 760). Sixteen cardiac deaths occurred in the 63 patients with versus 1 cardiac death among the 147 without a new wall motion abnormality (por = 0.0001). Other variables associated with cardiac death (por = 0.05) were age65 years, nitrate therapy, ventricular ectopy during DSE, suspected angina pectoris, and hospitalization at the time of DSE. When cardiac death, myocardial infarction, and revascularization procedures were all considered as adverse outcomes, a new wall motion abnormality continued to be the most powerful predictor of an adverse cardiac event.(ABSTRACT TRUNCATED AT 250 WORDS) |
| Databáze: | OpenAIRE |
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