Comparison of ischemic response during exercise and dobutamine echocardiography in patients with left main coronary artery disease

Journal of the American College of Cardiology
C H AttenhoferJ B Seward

Abstract

This study sought to compare manifestations of myocardial ischemia evoked by exercise and dobutamine echocardiography in patients with left main coronary artery disease. During exercise testing, left ventricular cavity dilation, marked ST segment depression and blood pressure decrease indicate severe coronary artery disease. Whether these signs are comparably evoked by dobutamine echocardiography has not been described. Fifty-four patients who underwent stress echocardiography (36 exercise, 18 dobutamine) and coronary angiography showing > or = 50% left main stenosis were analyzed. Electrocardiographic and blood pressure changes, symptoms, wall motion score indexes and sensitivity for coronary artery disease were compared. In 47 patients, the left ventricular endocardium was traced to quantify volumes and ejection fraction. Stress-induced regional wall motion abnormalities developed in 91% of patients; this was not different on exercise (89%) or dobutamine echocardiography (94%). Rate-pressure product and wall motion score index, similar at rest, tended to be higher after exercise than after dobutamine stress (p = 0.07 and p = 0.05, respectively). ST segment depression > or = 1 mm was more common with exercise (p = 0.005). Ejec...Continue Reading

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Mar 25, 2011·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·Nowell M Fine, Patricia A Pellikka
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