Abstract

AZPIRI-LOPEZ, José Ramón et al. Usefulness of transesophageal dobutamine stress echocardiography to detect ischemic heart disease. Arch. Cardiol. Méx. [online]. 2002, vol.72, n.2, pp.105-114. ISSN 1665-1731.

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 µg/kg/min), with high dose-dobutamine (28.7 ± 10.5 µg/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 ≥ 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.

Keywords : Echocardiography; Transesophageal; Dobutamine.